Carrying on for Dr. Tiller

One of the most remarkable things about the superb new documentary film After Tiller, from directors Martha Shane and Lana Wilson, is that it was made at all. Given the violence and harassment that abortion providers have endured for years, this group has, quite understandably, been very concerned with security issues and has been highly selective about dealing with the media. It is not unusual, for example, when abortion doctors appear on television with their faces shadowed and their voices altered.

Yet in After Tiller, the young filmmakers gained extraordinary access to four abortion providers—access which includes not only extensive coverage of their abortion practices but, even more unusually, their family lives as well. The willingness of the four doctors profiled in the film—Leroy Carhart, Warren Hern, Susan Robinson and Shelley Sella—to participate perhaps stems from the fact that they already have been repeatedly outed—or, more correctly, vilified—by the anti-abortion movement. These four physicians are the most visible of the tiny handful of abortion providers  today who are willing to perform abortions in the third trimester of pregnancy—abortions which represent only 1.5 percent of the more than one million abortions taking place each year in the United States, but which draw disproportionate and extreme reactions from abortion opponents.

Drs. Carhart, Robinson and Sella worked directly with the late Dr. George Tiller in his Wichita clinic, before he was assassinated by an anti-abortion fanatic, while Dr. Hern, who has his own clinic in Boulder, was a longtime colleague and close personal friend of Tiller. Both the immense tragedy of Dr. Tiller’s brutal slaying and the tremendous contribution that he made to this very specialized branch of abortion care are themselves additional “actors” in this film. There is no question that these four doctors—and the filmmakers themselves—see this film as an opportunity to honor Tiller’s memory.  The patients who present for abortions in the third trimester typically are those whose wanted pregnancies have gone horribly wrong, either because of a serious or lethal fetal anomaly or a serious illness of the pregnant woman herself.

In his Wichita practice, Dr. Tiller pioneered an extensive set of emotional support services for these patients, whose procedures often involved a four-day stay. Patients were offered access to an on-site chaplain or another religious figure in the community, if requested, and careful discussions were held as to how to explain to others why these visibly pregnant women returned home from Wichita not pregnant. The induction method used by Tiller meant the women essentially went through the labor process and delivered a stillborn baby—and the word “baby,” not “fetus,” was used with these patients. This induction method meant that women and their partners had an intact body that they could hold and grieve after the procedure, if they wished to.

After Tiller’s murder, Drs. Robinson and Sella went to work at Southwestern Women’s Options in Albuquerque, N.M., a clinic owned by a longtime friend of Tiller’s who was gratified to see this level of abortion care continue. Dr. Carhart, who was faced with extreme political opposition when he tried to continue this work in his home state of Nebraska and then in Iowa, eventually opened a clinic in Germantown, Md. Throughout the film we see evidence of these doctors, and their excellent counselors, continuing the practices developed by Tiller, offering the most compassionate care possible to women at one of the most difficult times in their lives. A sobbing women in Albuquerque, for example, whose male fetus was diagnosed with a condition that, if he survived at all, would suffer with terribly, says to a counselor, “The most loving thing is to let him go… Here, at least, he can have a… dignified birth, and I can hold him afterward.”

The film shows the immense strains of this work: Carhart, Sella and Robinson all spend much time on airplanes, away from their homes, and all four have received unwelcome attention from anti-abortion extremists. At the same time, After Tiller makes clear how profoundly gratifying it is to be of service to these women—and to continue the journey of their mentor and friend.

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