This article appears in our 2013 Fall issue, Gray. Subscribe today!
On May 31, 2009, Dr. George Tiller was shot dead while ushering Sunday morning service at his church in Wichita, Kansas. Tiller was the medical director of one of the few clinics in the United States that provided late-term abortions. His murder made the polarizing issue of third-trimester abortions an even starker debate. The powerful 2013 documentary After Tiller, which explores the day-to-day lives of late-term abortion providers like Tiller, is now available on Netflix and iTunes.
An abortion is typically considered “late-term” when it occurs after the 20th week (the start of the third trimester) of pregnancy. These procedures make up less than 2 percent of abortions in the United States each year, but according to a 2007 Gallup poll, 72 percent of Americans believe that late-term abortions should be illegal. One common misconception is that women who pursue third-trimester abortions do so out of recklessness, having thoughtlessly neglected to seek medical attention earlier in their pregnancies. After Nebraska passed a law in 2010 banning abortions past 20 weeks, several other states adopted similar laws, making it more difficult than ever for women to find late-term abortion providers.
The media blitz that swelled up around Tiller’s death left Brooklyn-based curator and filmmaker Lana Wilson with more questions than answers. After learning that Tiller had also been shot in 1993—only to return to work the next day—Wilson was driven to find out more about the handful of doctors who continued to risk their lives every day to carry out their work while wrestling with the ethical complexities and political controversies that surround their profession. Wilson approached her former classmate Martha Shane about the possibility of collaborating on a documentary focused on these doctors. Shane, a documentary filmmaker, was no stranger to tackling taboo material related to sex and sexuality. Having produced Bi the Way, a feature-length documentary about bisexuality in the United States that premiered at South by Southwest in 2008, Shane quickly agreed to join Wilson on the project.
Writing in their director’s statement that “our agenda is not political, but humanist,” the pair focused their lens on the lives and experiences of the doctors and their patients in order to highlight an often-overlooked gray area of an issue so frequently painted in black-and-white terms. “We definitely knew from the start that we wanted to frame [the film] from the doctors’ perspective,” Wilson said. “We didn’t want to make a comprehensive look at the abortion debate, or even a comprehensive look at third-trimester abortions. It was really more about what the experience of these four people is like every day.”
They started by calling LeRoy Carhart and Warren Hern, two doctors who had been trained by Tiller and were his close friends. Carhart, who practices in Nebraska, and Hern, who is based in Colorado, were immediately receptive to meeting, even though Hern told the filmmakers that the subject matter would not make for an enticing film. It took longer to secure the participation of Susan Robinson and Shelley Sella, the two female doctors featured in the film, both based in New Mexico. Initially wary of the potential ramifications of a media spotlight, Robinson and Sella eventually agreed to do the film in part because they didn’t want men to be the only onscreen representatives of their practice. The two doctors were also moved to participate after learning of the filmmakers’ plans to center the stories of patients. Patient interviews would aid the audience in understanding the extremely painful circumstances that typically lead women to pursue late-term abortions, such as fetal anomalies or complications that can endanger the woman’s health and life.
Aware that establishing a high degree of trust with the clinic workers and patients would be key in order to hear their stories, Shane and Wilson worked with a small, all-female crew. This enabled them to shoot footage without disrupting the work going on in the clinic. “It was just Lana and me and one other female cinematographer,” Shane said. “So we were able to fade into the background as much as possible. We weren’t an aggressive presence in the clinic at all.” This unobtrusive approach allowed the filmmakers to delve deeper into the daily operations of the clinics while fostering stronger connections with the patients. “It’s funny, I’m so sure we couldn’t have made this movie if we weren’t women because we wouldn’t have gotten access,” Wilson explained. “I don’t think there’s any way that the patients would have felt comfortable talking to us if we weren’t women.”
The filmmakers’ restrained, respectful, calm engagement with the patients and doctors is reflected in the visual style of the film and represents a conscious effort to neutralize some of the sensational theatrics that commonly frame media coverage of women’s reproductive rights. Wilson contrasted this understated cinematic style and more personal interviewing method with another documentary that deals with the abortion debate, Tony Kaye’s Lake of Fire (2006). “It’s just a polar-opposite approach,” Wilson said. “[Lake of Fire] is literally filmed in black and white…It’s a lot of really interesting intellectual discussions about philosophy and ethics, but in a very removed way. It’s either very intellectual or it’s all about the procedure.”
Making a feminist film with a balanced tone about such a charged subject proved quite a challenge. “The third-trimester abortion stuff is so complicated and messy in some ways, it’s hard to see it as a good vehicle for feminism,” Wilson said. Late-term abortions are only conducted after the doctor has assessed a patient’s case by talking with her and considering her medical situation. In the film, Robinson speaks about her struggle to negotiate this position of judgment: “Where does it come from that I get to say, ‘Oh yeah? Well, why? Why do you want an abortion? You explain to me, justify it to me.’ Why is that fair?”
Abortion-providing doctor Susan Robinson, who is featured in After Tiller (Ro*co)
Lana Wilson adds: “But as Dr. Robinson says at the end of the film, even if some women aren’t good storytellers, or aren’t articulate [about why they’re getting a late-term abortion]—it doesn’t matter. What matters is [that] this is her decision. That seems like a very crystallized explanation of feminism.” Wilson cited the example of a 16-year-old woman who appears at the end of the film, seeking an abortion after emerging from a long period of denial about her pregnancy. “You look at her and think, ‘Did this girl have access to comprehensive sex education? Did this girl have a responsible adult who she could talk to? Was she coerced into having sex because she grew up in an environment where male approval is the most important thing?’” Shane noted, “All the doctors [in the film] would consider themselves feminists. Dr. Robinson says she believes women are the experts on their own lives and are capable of making complicated ethical decisions. And unfortunately, that’s not necessarily the norm or [the] totally accepted view in our society.”
Throughout the process of making the film, Shane and Wilson were grateful for the advice, insights, and mentorship offered by female filmmakers they had long admired. Members of the thriving community of female documentary makers, such as Heidi Ewing (Jesus Camp, Freakonomics, Detropia), were especially helpful. “From the beginning, we could just cold call a female filmmaker we admired and ask for advice and they’d give it to us,” Wilson recalled. “All these other women filmmakers have been so generous and given us so much advice. We’ve been so dependent on them, I don’t know how we would have made some decisions otherwise. And I think that’s really important too, to have female filmmakers help younger women get involved.”
Having the support of women along the way proved vital, as the film industry is notoriously gendered. “One of the biggest barriers to women filmmakers is that most directors are men, the crews are men, the gatekeepers to the finances are men,” said Wilson, who admitted to feeling timid about pursuing funding for film productions prior to After Tiller. “I think it’s a lot harder for women to ask for money for their films than men. [Before this film,] I could not bring myself to ask for money or help. It always felt so selfish, like a vanity project. There are so many other things that people could be giving money to. But for this project it felt like literally the most important subject in the world, so I felt great asking for [funding].”
And while at times Shane and Wilson were underestimated for being young women, they discovered ways to use it to their advantage. Frequently mistaken as students working on a school project, they turned the incorrect assumption into an opportunity to further put the patients they interviewed at ease. Shane encourages other young female filmmakers tackling controversial subjects to find similar opportunities amidst misconceptions. “Use the fact that people don’t necessarily take female filmmakers as seriously,” Shane said. “Nobody thought our film was going to get into Sundance. And you can use that to your advantage. That means people feel comfortable with you and are more likely to be in your film, especially if you’re making a difficult [one] like this.”
Not only did After Tiller get into the Sundance Film Festival, it emerged as standout during its theaterical release in 2013 and won an Emmy for Best Documentary in 2015 after airing on PBS. “We’ve been shocked by how positive it has all been, just really shocked,” Shane said. “We went into Sundance and we had prepared ourselves, we practiced our responses to the more hostile questions we thought we might get, and we expected to have protests, have some anti-abortion people speak out from the audience. But really, we’ve been blown away by how everyone has responded so positively and everyone has said ‘We learned how complicated this situation really is.’ I think it’s provoking people to think hard and critically about their own opinions.”