Review: After Tiller


Note: This article was originally published at Movie Mezzanine.

Say what you will about anti-abortion activists: I’m convinced those signs work.

You know the ones I’m talking about. There are usually a few of them at every anti-abortion protest and rally, large banners depicting graphic, gory images of aborted fetuses. They’re obnoxious, sure, but I assume they’re effective, and not only because abortion opponents haven’t stopped using them.

There’s a common understanding between the majority of people that human life should be treasured, and feeling that something or someone is a Person Like Me can often change how we treat them more than knowing that they are. The goal of these signs is to provoke viewers into reaching the conclusion that an unborn fetus is a human being through emotional rather than logical means. They’re a gut-punch to the conscience, relying on our collective desire to not be people that dehumanize other people. It’s harder to support abortion once we view a fetus as a person, and on a visceral level, those unborn babies do look a lot like live ones.

Well, that approach to an issue can go both ways.

One of the greatest documentaries about abortion, Tony Kaye’s decade-in-the-making Lake Of Fire, acknowledges the complexity of the debate by taking an intellectual approach, allowing a wide variety of people from different walks of life to share a diverse range of opinions. Its ultimate conclusion is that abortion is one of those issues that connects with people on such an emotional and fundamentally human level, it’s impossible to find a “right” way to view it. It’s not a black-and-white topic, and relying solely on logic to find a definitive answer that applies to all cases can take us to some uncomfortable—and downright immoral—places.

After Tillera new documentary from directors Martha Shane and Lana Wilson, uses the exact opposite approach to reach a similar conclusion. It follows the four doctors in the United States who perform late-term abortions, and it doesn’t expand its scope beyond that. By focusing on the most extreme cases of abortion and following a small group of people, it accomplishes exactly what those anti-abortion banners do, but in a quieter and less polarizing way, asking viewers to look at the people onscreen and recognize a part of themselves.

The film begins by introducing us to the only four surgeons in the United States who are allowed to perform late-term abortions. Dr. LeRoy Carhart enjoys raising horses until his stables are set on fire by anti-abortion activists. Dr. Warren Hern decided to provide the service after working in rural Peru and seeing dozens of female patients who tried to self-abort due to the unavailability of the procedure. Dr. Susan Robinson is compassionate, often struggles with whether to provide abortions for certain patients, and Dr. Shelley Sella is a lesbian who at one point acknowledges that if we ignore the women asking for late-term abortions, the procedure seems “barbaric.”

All of them knew George Tiller, the practitioner who was shot and killed by an anti-abortion activist in 2009, and his death hangs over every scene. But unlike the right-wing stereotype, which often paints abortion doctors as gleeful baby-killing sadists, they seem just like you and me, normal people who often struggle with the day-to-day obstacles of their job.

Once it has established the essential humanity of these four practitioners, After Tiller turns to the patients who come to them seeking late-term abortions. We’re shown close-ups of wringing hands and the doctors’ reactions, but the faces of these women are never revealed; it’s a fly-on-the-wall technique that forces the audience to pay attention to their stories and explanations about why they want the procedure.

In these moments, the physicians often act as therapists, guiding patients (and the audience) through the decision with the goal of helping them realize whether this is something they really want to do. By presenting these encounters without flashy visuals or editing, Shane and Wilson allow the complexity and humanity of everyone involved to shine through.

No patients are there for the same reason, and it’s impossible to fit them into any pre-conceived stereotypes. Many of them have recently learned through prenatal testing that their child will be born with horrific defects or genetic diseases and will live short lives full of pain. One young woman is a rape victim who spent months living in denial and filled with guilt. Another is a teenager who’s being pressured by different people in her life to have another baby she doesn’t want. And one patient even admits to only waiting so long because she couldn’t afford an abortion during the first or second trimester.

It’s easy to want to assign blame to certain individuals, to claim that they acted irresponsibly, or that they don’t “deserve” to be allowed to end their pregnancy. Legally speaking, they are equals, and the doctors do their best to advise these women without judging the decisions and circumstances that led them here. However, they are not obligated to perform late-term abortions, and we get to witness the heated debates that surround not only the patient’s choice, but the surgeons’ as well. It’s in these moments that After Tiller shines, recognizing that these people are often just as uncertain and agonized over the issue of abortion as the rest of us.

Shane and Wilson understand that the best way to solve an argument is to force people to find common ground. By putting a human face on an issue that’s usually talked about in cold, abstract terms, they achieve through quiet observation what those pro-life banners aim to do through loud provocation, challenging viewers to engage on a level that goes deeper than political labels and talking points. The operation itself is never shown onscreen, not just because it’s a long and complicated process—late-term abortions involve two procedures and inducing labor of a stillborn baby—but because this isn’t a movie about a procedure, it’s about the people that make the decisions that lead there. In this respect, it’s a decidedly pro-choice movie, but it also never treats the fetus as anything other than a life. Everyone understands that they are choosing to terminate a fetus that is only weeks away from being a living human being outside the womb, and the decision is never made lightly.

After Tiller is a masterpiece of compassion. It’s one of the most humanistic and empathetic films I’ve seen all year, confronting the audience with a simple fact often undermined in the abortion debate: these doctors are people, too. They might not always make the right decisions, and there are no easy answers to be found, but like the rest of us, they’re doing their best to figure it out, one day at a time. This is a movie that should be seen by everyone, regardless of their politics, because it goes beyond simplistic notions of “pro-life” and “pro-choice”—after all, the film seems to suggest, aren’t life and choice meaningless without a certain amount of love?

Grade: A+