Review: 'After Tiller'

“After Tiller” is purportedly an apolitical documentary that exists to provide a voice to the four doctors who provide late abortions in America, but Martha Shane and Lana Wilson’s film is resolutely pro-choice. Not that this urgent and illuminating portrait ever explicitly takes sides in one of our nation’s most heated debates (though the directors are both admittedly in favor of reproductive rights), but “After Tiller” is nothing if not a compelling argument for the power of personhood, less of a topical message movie than it is a necessary reminder that – to paraphrase one of the doctors in the film – people are the experts of their own lives.

Dr. George Tiller was one of the only doctors in the country who performed legal third-trimester abortions, until he was assassinated by a “pro-life” extremist at church one morning in 2009. Tiller’s death, a tragedy by any measure, was also a severe blow to our nation’s ability to provide an urgent health service to women in crisis, as America was left with only four doctors who openly provide abortions after the 25th week of pregnancy. While there are thousands of professionals who have the training required to perform the operation, state laws, personal scruples and constant threats of violence have resulted in a negligible and easily accountable pool of willing practitioners. “After Tiller” is the story of those four doctors, Shane and Wilson’s film giving a microphone to a brave coalition whose voices are so often lost in the deafening protests to their actions.

Dr. Susan Robinson and Dr. Shelley Sella are two of Dr. Tiller’s former co-workers, a team who vowed to continue on their slain colleague’s mission in the wake of his murder. Based in California, they alternate weeks flying to their new practice in Albuquerque, New Mexico. 74-year-old Dr. Warren Hern has survived a long career as a provider of late abortions, but his personal life has suffered enormously due to the nature of his work and the threats that it invites. Dr. LeRoy Carhart, perhaps the most prominently featured member of the cast, only began to provide third-trimester abortions in the wake of Dr. Tiller’s death, a direct response to the intimidation tactics that have long confronted America’s abortion providers, eight of whom have been murdered for their work since 1993. When we meet Carhart, the Nebraskan doctor is actively looking to relocate his practice due to new state legislature that prohibits all abortions after the 20th week.

Shane and Wilson have stated that they hope to “shed more light, rather than more heat” on the issue of late abortions, and to that end their film determinedly resists polemic – while “After Tiller” gives far greater attention to the providers than it does to their protestors, that imbalance merely serves to help viewers see things from their perspective, not to argue on their behalf. This is ultimately a documentary about people rather than politics, the film structured so as to help us see through their eyes and better understand both why and how they do what they do. These doctors are inured to the constant wail of threats and accusations that anti-abortion extremists hurl at them from outside of their clinics – the menacing late-night phone calls, the apoplectic town hall meetings and all of the other tactics through which they attempt to impose their judgements on the desperate women who visit these facilities are little more than white noise to the medical professionals featured in the film, and so they are to the film itself.

While Carhart, Hern, Robinson and Sella are all compelling subjects, “After Tiller” is less interested in plumbing their individual quirks than it is in affirming their basic humanity. Blessed with a kind demeanor and a restless conscience, in another life Dr. Robinson might have been the platonic ideal of a school nurse, and to see her wrestle with the final decision of whether or not to approve a patient for a late abortion procedure is to understand how fundamentally humane these clinics are.

Less than 1% of the abortions performed in America are considered late, and the women who seek them often (almost always) do so in response to learning of grave fetal abnormalities. All of the anonymous patients who appear in the film are profoundly upset to terminate their pregnancies, but ultimately feel as though sparing their unborn child a short life of pain and unimaginable hardship is the greatest expression of love available to them (as one of the doctors says, “It’s not just about being alive, it’s about life and what that means”). The film also portrays one patient who knows that she won’t be able to provide for her child, who saved up for the expensive abortion procedure that the government wouldn’t pay for or subsidize, but only managed to collect the necessary funds after she entered her third trimester. She’d offer the baby up for adoption, but she knows that as soon as he was born it would be impossible to let go. One woman is in severe denial about the fact that she was pregnant, another is an anti-choice advocate whose pregnancy resulted from being raped. One woman isn’t a woman at all, but a 14-year-old girl who emails one of the clinics in malformed english.

Some of the women who visit the clinics have compelling reasons as to why they’re good candidates for a late abortion, others do not. Given that she practices in a state where the final decision is left to the doctor, Dr. Robinson is faced with the unenviably impossible task of arbitrating life, and while she is not divinely graced with an infallible sense of judgement, her function is ultimately to restore the human element to one of our most irreducibly human dilemmas. The fact of the matter is that abortions are going to happen no matter what, and we have a responsibility to make sure that they are professionally performed in a safe environment that provides both physical and mental care for the patient during the most sensitive time of their lives.

The human imperative informs every aspect of “After Tiller”, resulting in an unexpectedly warm film. Viewers bracing themselves for another documentary in the vein of Tony Kaye’s brutal and ambiguous “Lake of Fire” may be pleasantly surprised to find that Shane and Wilson have honored the character of their subjects rather than that of their work – it’s noted in the movie that the outside of an abortion clinic looks like a fortress while the inside is an adamantly nurturing environment, and “After Tiller” certainly spends the brunt of its too-short running time within the confines of those medical facilities. Levity abounds, and if the film is never an outright breeze it’s nevertheless enjoyably paced, the filmmakers cohesively bouncing between the four subjects, allowing just enough personal detail about the doctors for these portrayals to feel casually comprehensive. “After Tiller” isn’t a Frederick Wiseman-esque verité exercise or a gauche assortment of talking heads, it splits the difference as an organic portrait of four doctors whose work has come to define their lives, and from the film we feel as though we glean the same degree of information about these people that a patient might during the time before arriving at their final decision to undergo the procedure. If the film’s gentle, even-keeled approach is the result of hyper-conventional documentary tactics (attention to which is called by an occasionally obtrusive score and an over-reliance on local news footage), the humility inherent to this approach befits the stoic work performed by these doctors, and the soft touch with which they must perform it.

“After Tiller” is ultimately so vital because it eschews political grandstanding in order to reveal just how irrelevant the abortion debate to someone sitting in that room, contemplating whether or not to terminate their fetus and deliver it as a stillborn. Both the film and its subjects implicitly reveal how uselessly misleading the prevailing rhetoric has become, exposing the fallacy that opponents of the “pro-life” movement are inherently “anti-life.” This is not a film in favor of abortion, but one that insists upon the need for choice, because sometimes that’s the only thing a person has left.

SCORE: 8.5 / 10