‘After Tiller’ Review

Dr Carhart

Dr. LeRoy Carhart is looking for a fight. He admits as much himself. He’s an abortion provider sick of being run out of town, tired of watching the anti-abortion movement achieve political victories. He was forced out of Nebraska when a law banning abortion after 20 weeks was passed, and when he tried to move his practice to Iowa, the town fought back. He and his family have been harassed for years. It’s no wonder that he sees the fight over late-term abortion as a war.

Dr. Carhart’s bitter perspective, then, makes the tone of Martha Shane and Lana Wilson’s documentary After Tiller even more impressive. Late-term abortion might be the single most controversial issue in American politics today, and those on both sides of the issue often view their opponents as violent maniacs. Yet Shane and Wilson have crafted a film, within four women’s health clinics, that brings conversation and discussion to a subject so defined by slogans and screaming. More than simply informative (which it most certainly is), After Tiller is a reminder that seeing eye-to-eye is rarely as impossible as we might think.

The film is titled after the murdered Dr. George Tiller, who was gunned down in church in 2009. There are only four remaining doctors in the country who will perform late-term abortions, and all of them are former employees of the slain physician. They are Dr. Carhart, Dr. Warren Hern in Colorado, and Drs. Shelley Sella and Susan Robinson, who work out of the same clinic in New Mexico. Shane and Wilson spent time in their offices, interviewing them and observing the way that they process patients. The degree of honesty is refreshing, as none of the doctors shy away from the real ethical conundrums of their practice.

The biggest issue is third-trimester abortion. The procedure is, essentially, the euthanasia of the fetus and the inducing of labor. Dr. Sella is the most explicit about this, explaining that for her it is no longer a fetus, but a baby. Her frankness is striking. “Unless people understand what’s going on for the woman it’s impossible to support it. It sounds barbaric, doesn’t it?” That understanding is what drives these doctors to continue their practice.


For Dr. Hern, the central issue is one of public health. For Dr. Robinson it has to do with the right of women to make their own decisions. In Kansas, she was required by the state to only administer an abortion if the woman had a “compelling” enough story. Now that she practices in a state with fewer restrictions, the challenge is a different one. She is now more thoroughly a doctor and less of a judge, though as the film shows, that line is much grayer than anyone would like to think. Still, she has a clear central principle: “I believe women are the world’s expert on their own lives”

Shane and Wilson are equally concerned with the women themselves and express this with a unique style. The women who come through the offices of these doctors are kept anonymous, yet their identities are not obscured with voice alteration or the blurring of the image. Rather, Shane and Wilson artfully film them at angles that do not reveal their faces. This element is crucial to the film. By only slightly obscuring their identities, the audience is invited to truly understand these women in a more visceral way than most other films would allow. One simply cannot comprehend the implications of an issue this personal without trying to understand the lives of those women who come to the offices of Drs. Carhart, Sella, Robinson, and Hern.

For the medical professionals, however, there is no anonymity. Dr. Hern’s mother gets calls from angry activists, as do many other family members of these doctors. Dr. Carhart is an equestrian enthusiast. His stable was burned down by arsonists, killing many horses and nearly killing his daughter. Every element of the political fight over abortion is colored by violence. The murder of Dr. Tiller did not end the pressure, only aggravated it.

It certainly seems like a war. Yet so much of the hatred, so many of the vicious emotions involved come from a lack of communication. After Tiller is informative to humanize, an offering of open dialog to a conversation that so often reduces to shouting. As Dr. Robinson points out, “Nobody wants an abortion.” The stories involved are simply too complicated for there to be an instant, blanket answer for each and every woman in need. To quote Dr. Sella, the principle is “not just about being alive. It’s about life and what does it mean.” After Tiller will likely not magically solve the communication problem on this issue, but it does seem to assert that mutual understanding is at least possible.

After Tiller is now playing in New York City and opens in L.A. on October 4. For more info and playdates, see the film’s official website here.

Daniel is a freelance critic living in Brooklyn. His writing has appeared at Nonfics, The Film Experience, The Brooklyn Rail, Indiewire, and Dok.Revue.