A few months ago, I chatted with a newly pregnant friend over ice cream. Eventually, after we exhausted the areas of the politics of maternity leave and the excitement of decorating her baby’s room, our conversation turned to reproductive choice. Specifically, we talked about her decision to terminate her pregnancy if she and her husband learned that the fetus had developed a major chromosomal abnormality that would drastically decrease its chances for a viable, healthy life. Although both she and the baby were currently healthy, and tests proved that the likelihood of such abnormalities was negligible, she and her husband chose to keep the option of abortion on the table, in case they truly needed it later in the pregnancy. “I want to be a mother,” she told me, “but I want my child to have the best possible chance at life.”
I am relieved that, for my friend’s sake, this is probably not a choice on which she will need to act. In all likelihood, her baby will be healthy and safe. But in case a difficult decision needs to be made, it is critical that such options exist for parents to consider. I thought about our conversation when I saw Martha Shane and Lana Wilson’s new documentary, “After Tiller,” an official selection of the 2013 Sundance Film Festival. Like my friend, the majority of the women featured in are women who want to be mothers. They want to have healthy, happy children, and they want to provide their children with the best lives possible. Yet, when faced with the reality that their babies will not have the lives for which they planned, the mothers choose the option that they believe will demonstrate the greatest display of love and dignity. “After Tiller” shares these stories through the perspectives of the mothers seeking third-trimester abortions and the doctors providing them.
“After Tiller” profiles Doctors LeRoy Carhart, Susan Robinson, Shelley Sella, and Warren Hern, the only four known physicians in the United States who perform third-trimester abortions. Of the four, Carhart, Robinson, and Sella are former colleagues of the late Dr. George Tiller, who was murdered by an anti-abortion extremist in 2009 and after whom the film is named. No longer practicing in Tiller’s home of Wichita, Kansas, the doctors have started businesses elsewhere — Carhart in Maryland and previously Nebraska; Robinson and Sella in New Mexico — in order to continue Tiller’s mission and legacy. (Never a member of Tiller’s former clinic, Dr. Hern has practiced in Colorado since the 1970s.) The importance of the work is the reason for their perseverance; at one point during the film, Dr. Robinson laughs with a mix of dedication and sadness, exclaiming, “I just thought the other day, ‘I can’t retire. There aren’t enough of us.’” Through interviews and scenes observing the doctors participating in their daily work routines, viewers gain insight into the motivations that initially inspired them to pursue this work and the passion that drives them to continue with it in the face of death threats and legal challenges to reproductive rights.
While the histories and experiences of the doctors provide context and details necessary to understand the controversy surrounding third-trimester abortions, where the film truly shines is in its sensitive, honest depictions of the mothers choosing to terminate their pregnancies. Shane and Wilson were granted access to film the consultations that take place between the doctors and patients both before and after the procedure. The anonymity of the mothers and their families is always protected; faces and names are never revealed. Instead, the camera focuses on the women’s body language – the anxious fidgeting of hands, the gentle caressing of round bellies. As they speak, their voices convey a mix of pain and commitment, creating a sense that, while they are reluctant to make the choice to abort, they understand that it is the best possible option for them and their babies. The doctors give them tissues and hugs while offering critical words of advice. (One of my favorite moments is when Dr. Sella tells a pair of grieving parents four simple sentences to repeat to anyone asking about their decision: “The baby was sick. We went for testing. The baby didn’t make it. It’s hard for me to talk about it right now.”) The exchanges in which the mothers seek counsel from their doctors are the most moving scenes “After Tiller,” as they allow a glimpse into decision-making processes that are rarely captured on film.
In the highly political discussions of reproductive rights and abortion legislation, it is often easy to forget that the women making these decisions for themselves are real people, with feelings and concerns and priorities. “After Tiller” opts to not focus on third-trimester abortion as a staple of the reproductive rights movement (the voices of organizations like Planned Parenthood and NARAL are not featured) but instead positions it in a highly personal realm. For audiences who are unfamiliar with the process and details of third-trimester abortions, this intimate approach may prove to be the most effective way to communicate its necessity as a legal, accessible procedure.
Just as I know my friend is not considering the slim possibility of her abortion lightly, none of the women who appear in “After Tiller” reached their decisions easily. Real women’s difficult personal struggles are what give the film its weight. The mantra of “Trust Women” was popularized after Dr. Tiller’s murder. “After Tiller” is the embodiment of that phrase, demonstrating the trust that parents and doctors place in each other when arriving at challenging, but necessary, decisions.
“After Tiller“ is now playing in New York City and will open in select U.S. cities throughout October and November.