Debut directors Martha Shane and Lana Wilson have accomplished a tricky thing with “After Tiller,” their documentary on the few openly practicing doctors of third-trimester abortions in the US which recently scored an Indie Spirit nomination for Best Documentary. They cut out the white noise, and focus on a simple question: Who are these unusual individuals?
In 2009, Dr. George Tiller was assassinated while at church in his Kansas hometown. Since his death, there are only four doctors in the United States openly providing third-trimester abortions -- Dr. LeRoy Carhart in Maryland, Dr. Warren Hern in Colorado, and Dr. Susan Robinson and Dr. Shelley Sella in New Mexico. These physicians, all of whom were either friends or acquaintances of Dr. Tiller’s, know the risks they run as they continue their practices. They have had to endure vicious defamation, and the possibility of physical harm is never far from their minds.
In one scene, we see Dr. Robinson chuckling about the lofty situation of her house -- a difficult target for a sniper-like attack. Dr. Carhart recounts a story of his entire horse corral being burned to the ground in an act of terrorism. 18 horses perished; luckily the Carharts’ daughter was not working in the stables at the time of the attack. Carhart and his wife subsequently had to undergo an exhausting cross-country search for a new office location, when his home state of Nebraska passed the “Fetal Pain Act,” illegalizing abortions performed later than 20 weeks.
Aside from these acute worries, there is the mentally wearing daily grind of walking past protesters -- some who call out, some who are lost in prayer -- as the doctors make their way to and from their offices every morning and evening.
“After Tiller” acts as a portrait of the doctors, and of their various patients -- all of whose identities are kept anonymous -- who seek out the expensive and difficult procedure for a host of reasons, each one complex and not without trying deliberation. Many patients’ fetuses have severe or fatal abnormalities, discovered late in their pregnancies. If the children were brought to term they would have a gravely compromised quality of life, if they survived at all.
Meanwhile another patient’s pregnancy is the result of rape; one patient has had to put off the procedure as she waited for adequate funds to come in; one is 16 years old and has spent months struggling with the decision, amid strong family pressure. As is the case in life, some of the thought processes we hear are clearly defined, and others are not.
Directors Shane and Wilson take a startlingly and refreshingly apolitical approach to the film. Their camera is in these offices to observe. The doctors they film, however, are in the more difficult position of passing judgment. As Dr. Robinson explains during one of the documentary’s most compelling sequences, she upholds a rigorous selection process for who qualifies to receive the procedure -- and who doesn’t. She understands this as both necessary from a health standpoint but also ironic: Who is she to decline an abortion for a patient, when her practice is about patients making decisions for their own bodies?
What perhaps is so radical about “After Tiller” is that it refuses to be caught up in our culture’s loud and confusing clamor surrounding abortion. It should be seen by moviegoers both for and against abortion rights, and indeed raises issues that work in favor of both sides. Its gift is letting us glimpse at people “on the ground” in this issue, and presents them only as what they are: Humans, struggling with ideals, moral dilemmas, responsibilities and the safety of themselves and those they can help. In that vein, I would be fascinated to see a documentary as even-handed and dispassionate on those who picket outside these women’s clinics.
Dr. Robinson says ruefully at one point in the film, “Nobody fucking wants an abortion.” This may very well be true. “After Tiller” allows us a fly-on-the-wall view of four strong individuals who deal every day, struggling through extreme outside disapproval and internal emotional exhaustion, with the service they believe strongly is needed, and yet no one wants.
"After Tiller" hits theaters September 20 in New York, and October 4 in Los Angeles.