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Sundance Dispatch: "After Tiller's" Surprising Intricacies

Both sides of the abortion debate aren't known for subtle shadings, but the Sundance documentary After Tiller, about the four American doctors who perform third-trimester abortions, doesn't preach.

PARK CITY, UTAH—Considering that there are only four doctors in clinics in the United States who perform abortions in the third trimester, it's impossible to apply a statistical model to such a small sample. But in After Tiller, a documentary directed by Martha Shane and Lana Wilson in competition at the Sundance Film Festival, the two male doctors seem absolutely sure of themselves and what they are doing, and the two female doctors do not. Or, at least, the two women, Susan Robinson and Shelley Sella, who run a clinic in New Mexico, seem worn down and conflicted by the choices they have to make every day; the men, LeRoy Carhart and Warren Hern, appear to feel that they have a calling. If the men worry about their decision-making, they don't express it here. This nuance isn't something I was expecting in After Tiller; it was fascinating.

It's Robinson in the photograph above, after rejecting a potential patient who had called from France — the woman was 35 weeks pregnant, a clinic screener who took the call tells Robinson, and had thought she wasn't because she'd had a negative pregnancy test.

Having to make these decisions for women clearly tears Robinson up. In order to perform an abortion at such a late stage, Robinson and Sella feel they need to be "compelled" by the reason — "horrific fetal abnormalities," would be one, as Sella says. But, Robinson asks rhetorically, "Why is that fair? What if you're just not a good storyteller?"

"Nobody fucking wants an abortion," Robinson says at another point.

Sella's ambivalence is about the entire process of the surgery: that at a late stage of pregnancy, the abortion is performed through labor and delivery. "I think of them as babies," she says. "That's not tissue; that's a baby." It's why, she says, almost no doctors do what she does.

All four doctors worked with George Tiller, the Wichita doctor who was assassinated in church in 2009, and they have both dedicated and literally risk their lives to perform late-term abortions. Beyond being a compelling portrait of these four people, After Tiller also shows the audience a cross-section of the reasons women turn to what the doctors offer. We don't see any patients' faces, but we hear them speak — most cases are planned pregnancies that have gone terribly awry: testing has revealed catastrophic problems with the fetus.

Tuesday is the 40th anniversary of Roe v. Wade, and the politics of abortion are not known for being expressed with subtlety. After Tiller — with its four real people revealing why they've chosen such hard paths — defies that.

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