“The key to success is not how many people we put in, but how many we keep from coming back."
On the fortieth anniversary of Roe v. Wade, hundreds of us who had tickets in hand to see the premiere of After Tiller at the Sundance Film Festival in Park City, Utah, were wanded and searched by police before entering the theater. It was a sobering moment.
On Sunday, May 31, 2009, George Tiller was gunned down at the Reformation Lutheran Church in Wichita, Kansas. He was one of the few doctors in America who performed late-term abortions. His assailant, Scott Roeder, was an anti-abortion activist who killed Dr. Tiller without regrets, simply stating, "Unborn children's lives were in imminent danger."
Two young women, Martha Shane and Lana Wilson, both in their late twenties, have now made this film, which focuses on the four colleagues he left behind. Three of the doctors -- LeRoy Carhart, Susan Robinson, and Shelley Sella -- all worked in Dr. Tiller's Wichita clinic. Warren Hern, a late-term abortion specialist, runs the Boulder Abortion Clinic in Colorado.
In an interview shortly after Dr. Tiller's assassination, Dr. Hern, who had five bullets come through his clinic's window in 1988, said this: "Every doctor in this country who does abortions lives under death threats. People talk about the debate over abortion. It's not a debate. This is a civil war, and the anti-abortion fanatics are using bullets and bombs."
Dr. Hern and the three other doctors who attended the premiere were given added security and protection from the FBI.
After Tiller focuses on complexities. No one comes to a doctor for a late-term abortion after a twenty-week pregnancy lightly. Many are women with planned pregnancies who find out late that there is something terribly wrong with the baby they are carrying. So they are not just going through a grueling procedure; they are grieving the loss of a child they dreamed of and wanted.
Yes, it is a choice, but not a choice made without a soul-stirring struggle. "It's guilt no matter which way you go," says one of the women who is choosing to terminate her pregnancy after finding out her fetus was facing a terminally incapacitating disability. "Guilty if you go ahead and do what we're doing or guilty if you bring him into the world because he would have no quality of life."
We watch her hands fidgeting as she holds a tissue. Anguish and empathy flood the screen.
The doctors struggle alongside their patients. "I think about what I do all the time," says Dr. Shelley Sella, who works with Dr. Susan Robinson at the Southwestern Women's Options clinic in Albuquerque. "At times I struggle, and at times I don't, but I always come back to the woman and what she's going through and often what life will this baby have? What will it mean to be alive with horrible fetal abnormalities? It's not just about being alive. It's about life and what that means."
Nine states allow for third-trimester abortions. Dr. Giovannina Anthony, an ob-gyn in Wyoming who has supported women who choose to have abortions, said, "Third-trimester abortions are extremely rare. They account for less than 1 percent of all abortions in the United States."
To see the human side of the four remaining doctors who follow in Dr. Tiller's footsteps is to feel deeply grateful for the option that still remains for women and couples in need of this difficult procedure.
Throughout the film, you listen to their stories: the couple whose baby has no chance of surviving; a woman who suffered the denial of rape, unable to cope with what lies ahead; and those women who hit the wall of poverty, of not being able to financially take care of another child. These were among the hardest to absorb. Most of the women worried how they would face their family and friends who were expectant with the joy and anticipation of a new being about to be born into the world.
Again, Dr. Sella counsels her patients:
Here are four sentences that can help you:
The baby was sick.
We went for testing.
The baby didn't make it.
It's hard for me to talk about it right now.
And the doctor repeats the four sentences once again for the patient to remember, so she can return home with something meaningful and true to share with loved ones.
Annette P. Cumming, a former nurse and lifelong advocate for women's reproductive health who serves on the national board of Planned Parenthood, appreciated the candor of the film. "I was deeply moved," she said. "After Tiller challenges even the assumptions of progressives."
She is talking about the fact that a late-term abortion can be a four-day procedure. "I didn't know that," Annette said. The woman must first participate in a counseling session; she returns to take a drug to ripen and dilate the cervix; the doctor then euthanizes the baby; the woman is induced and goes into active labor; and finally, the woman gives birth to a stillborn.
Surprisingly to some, Dr. Sella says on camera, "This is not a fetus. It is a baby." As Annette said to me after the film, "There is no distancing of language here." The baby aborted is held. We see one of the mothers who chooses to have her baby's hands and feet stamped and recorded in ink. It is impossible not to feel the grief that precedes and follows the delivery.
"The only time you'd be saying hello to your baby is when you are saying goodbye," Dr. Carhart says.
The women return to counseling after the delivery, and we see each one of them expressing a sense of relief, not regret. But it is not without the knife-blade of grief for the child they had dreamed of mothering.
The film highlights the personal life of each doctor. Both the male doctors, Dr. LeRoy Carhart and Dr. Warren Hern, served in the military. Dr. Hern was a physician in the Peace Corps. They are angry and determined to carry on the work of Dr. Tiller.
Dr. Susan Robinson and Dr. Shelley Sella seem more private in their work, traveling constantly from their respective homes in California, where they live, to New Mexico, where they practice.
Each of the physicians early in their medical careers made a decision to help women in the name of a just and democratic society. The judgmental and violent opposition against abortions bothered them. "A woman's body is smarter than the doctor's," commented Robinson. "They deserve to be given a safe choice regarding their own reproductive decisions."
Each of the doctors has paid a price.
Dr. Carhart's family stables were burned to the ground in Nebraska. Hey lost seventeen horses. Arson. In a letter that followed the fire, the protesters justified the killing of horses "since you kill children." It was his daughter's twenty-first birthday.
Dr. Hern, now more than seventy years old, has received "thousands of death threats." He has often slept with a rifle, and lives with the possibility that he might be shot every time he walks out the door. He is outspoken and resolute in his determination to continue his practice.
Dr. Robinson lives in a remote location in the mountains. One police officer, upon checking to see if she was safe, said, "Even the best sniper in the country would have a hard time getting a shot at this house."
And Dr. Sella said that she believes it was easier for her to "come out as being gay than it is for most women to admit to having had an abortion."
This is a film about hands.
The hands of the doctors who deliver the babies, stillborn, not kicking.
The hands of Susan Robinson covering her face as she ponders another young woman's story and whether as a physician of late-term abortions, she says yes or no.
"Who am I to say, 'No, that's not a good enough story'? What if you're just not a good storyteller? The point is," Robinson says, "she has made this decision. If I'm going to turn down a patient, it's because it's not safe and I can't take care of her."
There are the hands of Dr. Hern as he holds a young woman in his arms who has been raped and cannot stop crying.
The hands of Dr. Carhart as he carries his doctor's bag and walks past the protesters chanting, "Hey, hey, ho, ho, Roe v. Wade, it's time to go," and opens the door to a new late-term abortion clinic in Maryland against vitriolic opposition.
"People can disagree, but here we are. We are taking care of women," Dr. Carhart says. He, too, is a Christian.
After Tiller is a brilliant and brave film about taking an issue that has divided us for decades and showing us through the personal histories and practices of these four doctors who perform late-term abortions that first and foremost we are all human in our struggle to live a dignified and ethical life.
"To lift back the curtain and see how the doctors and their patients really wrestle with the moral dilemmas and choices before them is what we wanted to bring to the audience," said Lana Wilson, co-director of After Tiller, during the question and answer period following the film. "These are doctors striving to care for their patients; they are not ideologues or zealots."
For the first time in a while, public opinion on abortion appears to be moving in a progressive direction. An NBC/Wall Street Journal poll, taken on the fortieth anniversary of Roe v. Wade, showed 70 percent of Americans oppose overturning the controversial Supreme Court decision.
After Tiller opens the door to a mature discussion about the realities of women's reproductive health, allowing us to embrace the controversies and complexities associated with late-term abortions.
This is a film about listening.
Imagine if we as a society could offer our compassion, instead of our judgments. To do otherwise is to deny the terrible bind that so many women find themselves in -- and the anguish they go through in navigating their way through the emotional pain back to some semblance of peace.
Terry Tempest Williams's new book, "When Women Were Birds," received a starred review in Publisher's Weekly. It is now available in paperback by Picador.