After Tiller, Martha Shane and Lana Wilson’s probing documentary about the four doctors in the U.S. who perform late-term abortions, isn’t interested in engaging in a policy debate about a woman’s right to choose or when life begins. (It takes it as a given that the doc’s four subjects provide an essential service.) Instead, the filmmakers focus on the day-to-day activities of its quartet of physicians, observing them in consultation with patients, reflecting on some of the thornier ethical aspects of their work, and trying to maintain a normal life while the threat of death at the hands of fanatical pro-lifers looms large over their everyday existence.
Periodic footage of these Bible-thumping protestors is scary enough, particularly when the film begins by recounting the murder of the eponymous Dr. George Tiller, mentor to three of the film’s four subjects. But Shane and Wilson’s film is anything but histrionic, much of it unfolding in a sort of sacred hush in the inviolable space of the consulting room. As we see each of the four consult individually with their patients, we get a sense of the wide variety of circumstances that bring women to seek third-trimester abortions, from a belated discovery of crippling disease in the fetus to a hesitance on the part of scared teens to address the issue before it’s nearly too late.
Given that, in order to protect their privacy, the patients’ faces are never shown on screen, the focus in these exchanges shifts instead to the doctors, whose sympathetic demeanor as they listen to their charges’ stories and offer helpful encouragement, reveals them to be genuinely committed to the well-being of their patients and driven in their sometimes perilous tasks by the sense of the importance of their work. It’s in these consultations, whose running theme is a complete rejection of judgment on the part of the doctors, a stance totally opposite to that of the signs being perpetually waved just a few dozen feet away outside the clinic, that the film makes its true political statement.
But not everything is so ethically clear cut as this simple juxtaposition of sympathy and religion-fueled myopia. While the loneliness and isolation experienced by one of the doctors highlights the toll the film’s subjects’ work takes on their personal lives, and a change in state law forces a Nebraska practitioner to go state to state looking for a place to open a new clinic, it’s in focusing on a third doctor, Susan Robinson, that the film gets at some of the more fraught moral dilemmas.
This Albuquerque-based practitioner relates her own struggles in deciding which patients she accepts for treatment, admitting that those with more compelling narratives are more likely to be able to secure the help they need, when, in reality, she concedes, all women who’ve made the decision to undergo an abortion deserve that right. In the film’s saddest scene, she consults with an assistant over the case of a young woman who’s decided on an abortion as her best option, but whose religious upbringing has caused her to view the act as morally wrong. It’s in moments like this that we get a true sense of the precarious positions of both the doctors and their patients, having to contend with the forces of a hypocritically religious country that has warped the psyches of countless young women and burdened them with a lifetime of misplaced guilt.