I was surprised that the new Dead Ringers, a six-episode miniseries running on Amazon Prime, was able to find a way forward from the 1988 horror classic. And even more surprised that it was actually good.

The engine driving David Cronenberg’s original film was body horror trained on the female reproductive system from a voyeuristic male point of view (codependent twin doctors both played by Jeremy Irons), culminating in a grisly gynecological exam using shiny instruments of torture designed for gory invasive probing.

There’s plenty of gore in this version too, with a maximum use of blood red not only in the actual copious spilling of bodily fluids, but in clothing and the overall color scheme. The new state-of-the-art birthing center, which realizes the ambitions of the Mantle twins, Beverly and Elliot (Rachel Weisz), to revolutionize the reproductive industry — including the ways fertility, pregnancy, birthing, and aftercare are handled — features the same ghastly red scrubs worn by medical personnel in the original film.

The material has been reconceived by writer Alice Birch (Succession, Normal People, The Wonder) and star Rachel Weisz (The Favourite, The Constant Gardener, the Mummy franchise), who share executive producing credits, working with an all-female writing team. The new Dead Ringers approaches from a, shall we say, “insider’s perspective,” on such topical issues as infertility treatments, infant mortality, postpartum depression, and menopause, which are rarely depicted in mainstream media. Though some of this is engrossing, it also creates a narrative that has a schematic quality, as if positions on these topics related to reproduction came first and characters were designed second in order to articulate them.

Yet at the same time there are the lurid plot moves of Old Hollywood good-versus-evil twin melodramas that once starred Bette Davis (A Stolen Life, Dead Ringer) and Olivia de Havilland (Dark Mirror). They make for an odd combination, and Rachel Weisz does all that a talented actor can do in punching it across. She plays both tendencies well, throwing herself into the finer details, but not at all above relishing the cruder joys of traditional twin narratives, like the simple yet dramatic change in hairstyle that allows one twin to pass as the other with nobody able to detect the difference — not parents, not longtime lovers, and certainly not viewers if we weren’t tipped off.

Beverly, the “baby sister” by a few minutes, is the quiet, serious, proper one with idealistic dreams of making the reproductive experience natural and healthy for all women. She wears her hair parted in the middle and pulled back tightly in a bun, the hairstyle of prim types since the days of D. W. Griffith. Elliot, the wilder one defined by her voracious appetites and ethical shadiness, wears her shoulder-length mane of hair side-parted and swinging free. She’s always offering to procure lovers for the shyer twin Beverly (“Shall I get her for you?”), generally after initiating the sexual relationship that Beverly then has the option to continue. But Elliot’s boldness suggesting an apparently greater strength of character is an illusion — she’s the more dependent twin. She nearly has a psychotic breakdown when Beverly begins a lasting affair with an actor, Genevieve Cotard (Britne Oldford).

As many critics have noted, playing twins means twice as much Rachel Weisz, which is great. Maybe she could play quadruplets sometime and really fill the screen. Weisz has always been a lovely presence, but especially since her thrilling performance as the formidable Duchess of Marlborough, lover and chief advisor to Olivia Colman’s addled Queen Anne, in The Favourite (2018), Weisz now has a compelling woman-of-a-certain-age heartthrob status ideal for Dead Ringers. Mainly because the miniseries is too long at six one-hour episodes, and watching Weisz makes the excess length endurable.

Jennifer Ehle also scores playing icy, deadpan Rebecca Parker, scion of a billionaire family who funds start-ups. She’s an intelligent monster, who hosts the twins in a series of nightmarish dinners with her entourage of horrible toadies. Over one such meal she baits Beverly’s shaky ideals with sardonic lines like, “Ohhh, is capitalism bad?”

And there are a few other memorable turns by character actors in a generally excellent cast, including Susan Blommaert as an elderly, spiky, unapologetic, drug-addicted street person who has a memorable conversation with Elliot while she’s unraveling. Kevin McNally and Suzanne Bertish play the working-class parents of the highly accomplished twins, who show up for a visit that’s a cornucopia of nervous tension and half-buried resentments. And Ntare Guma Mbaho Mwine underplays nicely as a Pulitzer-winning ex-writer and professor brought low by his alcoholism and sexual transgressions, who revives his career reporting on the secretly scandalous twins.

Unfortunately, the storyline involving the twins’ housekeeper Greta (Poppy Liu of Hacks) starts off interestingly sinister and winds up veering off into an odd, unlikely development that seems half-baked at best. The whole last episode is beset by narrative implausibility.

The high production values of this “prestige TV” series help create an atmosphere of dread about all the ways that motherhood and family and reproduction and human relationships in general can and will go wrong through chilly, inhuman environments. There are lots of mirrors and reflective surfaces, many extreme, dissociative high-angle shots that reduce people to rats in a maze, an elaborate color scheme full of uneasy-making combinations of “wrong” colors, and lighting so remarkably dark and shadowy in spots, you can hardly see what’s going on.

As nakedly ideological TV goes, it’s at least ambitious. And if it doesn’t altogether work, you can always enjoy the simple pleasures of watching double Rachel Weiszes and wondering which sister will have to die to allow the other one to live a full life, as always happens in the old twin melodramas.