Review: After Tiller


Before After Tiller even began, I thought I knew how I was going to start this review: I was going to comment on the fact the few critics who showed up to a screening documentary about third trimester abortions in the audience were male. Sadly, film criticism is a predominantly male enterprise so perhaps I shouldn’t have been surprised, but it seemed wrong somehow. With a subject so focused on women’s rights, it seemed wrong that it would be a bunch of guys telling But just as the film began, several female critics showed up and took the wind out of those sails.

As the film progressed and after the credits rolled, I have since come up with a dozen other potential openers, but none of them really felt right. Each was as imperfect as the last and none got to the heart of the fact After Tiller is a movie that made me think, and it made me think hard. With each new interview, my feelings about third trimester abortions (and abortions in general) were formed and reformed. What once seemed at best ethically questionable is far more complicated, and I appreciate the film for explaining that in a clear and level-headed way.

A film blog is not the right place to open up a debate on abortion rights, but there is no way to talk about this film without at least discussing the controversy. My own feelings on the matter (I’m pro-choice) will color everything I’m going to say, but I’m not looking to pick a fight. If you agree/disagree with what I have to say about the film, go right ahead and say something. Let’s talk about what the film does right and what it does wrong. I’d love that.

But if you want to make a fundamental point about the legality or ethicality of abortion or make statements about the people who perform or have them, don’t. Flixist isn’t your soapbox and moral grandstanding from either side of the debate isn’t welcome.

With that out of the way, let’s get into it. See you on the other side.

Meet The Artists '13: Lana Wilson and Martha Shane

After Tiller
Directors: Martha Shane and Lana Wilson
Release Date: 9/20/2013 (NYC, more to follow)
Rating: PG-13

One last caveat before we get into this thing: if you’re squeamish or easily distressed, then you might not want to continue reading. I’m going to write openly about some of the more upsetting aspects of the film’s narrative, including discussing the process by which third-trimester abortions take place. Even if you’ve made it this far, there’s a pretty good chance you won’t see the final film. But I think it talks about some things that everyone should know about this extremely small group and the work that they do. So I’m going to repeat that information openly and frankly. It’s hard to really “spoil” a documentary, but if you are seriously planning to see After Tiller (which you should) as a blank slate, you might want to stop here.

As I mentioned in the subtitle, there are only four doctors in the entire United States who perform what are referred to as “late” abortions (not “late-term,” which is a descriptor that comes primarily from the practice’s opponents). These abortions, which make up less than 1% of all US abortions, take place during the third trimester of a pregnancy, which is usually defined as twenty-five weeks or later. When the famous (infamous?) Roe v. Wade Supreme Court decision was passed, its sanctioning of abortion rights did not necessarily guarantee the right of late abortions except in cases where the health of the mother is at risk. Although laws restricting or banning late abortions may eventually be challenged in court, they have been passed in a majority of US states. Only nine states allow for late abortions to be performed without restriction. Doctors trained and openly willing to perform them can be found in only three: New Mexico, Colorado, and Maryland.

All four doctors—clockwise: Dr. Susan Robinson, Dr. Shelley Sella, Dr. LeRoy Carhart, Dr. Warren Hernwere students of the late Dr. George Tiller, who was shot while attending church in 2009. I remembered the Tiller event, specifically seeing clips on The Daily Show of Bill O’Reilly and others calling him “Tiller the Baby Killer,” which is what compelled me to see this film in the first place. Few seemed to mourn his loss, and the irony of pro-life pundits celebrating death was not lost on me.

An NBC/WSJ poll from earlier this year found that 7 in 10 Americans believe Roe v. Wade should not be overturned (though this seems to be in pretty heavy flux at the moment and tends more towards 60%), but the the notes that accompanied the After Tiller screening point to a Gallup poll that says that only 1 in 10 Americans support late abortions specifically. So it is extremely likely that you, regardless of your general opinion of abortion, probably don’t agree with the practice of late abortions. Once a fetus has reached viability, the tenor of the debate shifts, and every one of these doctors understand that. Their methods involve inducing a heart attack in the fetus, a near-instantaneous death and then causing a natural birth of a stillborn fetus. The parent(s) have a chance to spend some time with their child, if they so choose, allowing for some level of catharsis.

The women who have these abortions come for all kinds of reasons, and the film lets many of them speak, sitting in on sessions where they explain to the doctors why they are there and how difficult it was to come to the decision. The patients’ faces are never shown; instead, the camera focuses on their body language and on the face of the doctor. It’s powerful, and it’s extremely sad. Their circumstances won’t allow them to have a child without destroying their own lives, or their baby would be born with a horrific defect that couldn’t be detected until after viability. Two of the doctors have not-quite-therapists on staff there to help ease the mental anguish, and the doctors themselves do what they can to help their patients. They understand why people hate them and why there is controversy, but they are doing what they believe is right.

Dr. Warren Hern

Of the doctors, the one I liked the most was Warren Hern, who works in Colorado. His connection to Tiller was somewhat weaker than the other three, and for the first part of the film it seems as though he’s alone. This is one of the few obviously manipulative parts of After Tiller, because it is eventually revealed that he has found a wife who accepts his work and has a family. But it’s also his reason for doing the work that I found so compelling. While in the Peace Corps, where he worked delivering babies, he watched dozens of women die from botched abortions and treated the severe wounds of unwanted children who had been beaten, sometimes to the brink of death. In his own practice, he met a woman whose cervix had been destroyed by a chopstick she had used in a failed attempt to abort her fetus. It’s hard to fault his career choice.

What convinced the other doctors is never made quite as explicit, or if it was it didn’t stick with me. That’s not to say I didn’t like them, but they didn’t resonate in quite the same way. They are all passionate and compassionate people who deal with protesters every day and occasionally real acts of violence (years ago, Dr. LeRoy Carhart’s stable was burned down and horses killed in the process). What happened to George Tiller could happen to any of them, and they know it, but they can’t quit. And that’s the most depressing thing of all. Every one of them is graying, and though the obligatory “Where are they now?” text at the end explains that a fifth doctor is currently being trained, one doctor can’t replace four. On several occasions, the doctors remark that they will continue to do the work until they physically can’t, because they have to.

The terrible irony of the whole thing comes from the revelation that Dr. Tiller was planning on scaling back his own work. He was going to turn over his clinic to Drs. Carhart, Robinson, and Shelley. He called Dr. Carhart and told him this two days before he was killed. And suddenly, Dr. Tiller’s murder seems even more senseless.

What After Tiller does is ultimately more important than how it does it. As a documentary, it is completely fine and nothing more. It’s not an amazing piece of art and it doesn’t push any sort of technical boundaries, but it shouldn’t be doing that anyway: Its purpose, stated or not, is to put a human face on an extremely controversial topic and explain why it’s not the black-and-white many seem to believe it is. It serves that purpose. 

Every so often, I’ll come across an article in the New York Times or something about abortions. I’ll read it, because I’m curious if they’ll mention late abortions. They don’t. I read a several thousand word article in the New York Times about people who got abortions and how they felt afterwards less than twenty-four hours after seeing After Tiller, and there was a very vague reference to New Mexico and nothing else. If abortion is a taboo subject, late abortions are avoided like the plague. It’s a shame, because there’s no way to have a discussion without informed people willing to discuss it.

With this film, maybe that discussion can finally begin.

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