After Tiller is an award-winning documentary film that takes us inside the lives of the remaining four doctors who were openly providing third-trimester abortions in the United States after the 2009 murder of Dr. George Tiller, a staunch defender and provider of those abortions. The 88-minute film, released in 2013, seeks to shed light, rather than more heat, and move beyond the national shouting match about abortion later in pregnancy.

You can see the trailer here:

Is this film for you? Probably, if you ponder the following:

1. Why would a pregnant woman wait so late into a pregnancy to decide to have an abortion?
2. Why would a woman who loves her unborn baby have a late abortion?
3. After 24 weeks’ gestation, should abortion (always, sometimes, never) be illegal?
4. What kind of people provide third-trimester abortions?
5. Do third-trimester abortions differ much from premature, natural childbirth?

The film takes us into the day-to-day goings on in the clinics and homes of the four doctors as they encounter protesters, see patients, and deal with constant threats to themselves, their families, and, in one case, 21 horses burned alive in their stalls by an anti-abortion arsonist. The focus of the film is on the complexity of the decisions women face when deciding to have an abortion later in pregnancy, and how the doctors help them navigate through those difficult times, both physically and emotionally.

Many fetal anomalies cannot be diagnosed until at least 20 weeks’ gestation, some of the most severe brain disorders much later. Prospective mothers and fathers, who agreed to be filmed with only their bodies shown, describe fetal anomalies and prospects for their child’s quality of life:

They said that the little baby’s bones are breaking inside the womb and that if he survives birth, he will live for three or four years in immense pain. Just holding him could break his bones. How could I bring our child into this world to suffer like that?

Another mother explained:

I was already 25 — going on 26 weeks … The MRI came back with what’s called Walker-Warburg lissencephaly … which is … fatal in a lot of ways. There’s no way to say when. It could be in utero. He could be a stillborn. He would have a very short-term life full of shunts, surgeries, and seizures until he would pass, so all the doctors that I talked to said that he’s not a viable child and that he would eventually just be vegetative, and the most loving thing I could do is to let him go now. We just didn’t want to have to make the choice later … I didn’t want to have him suffer any more than he had to. And it was really important that he had somewhat of a dignified birth … You know, the fact that we have the option to spend some time with him afterwards was really important.

Other women have been thwarted from an earlier decision by a myriad of complicated factors; some were in denial, others faced situations beyond their control (e.g., legal roadblocks, money, changing family circumstances, family pressure or fear).

Listening to the women’s stories, the viewer comes away with a sense of how complex their decisions are and how hard women struggle to do the right thing for themselves and their families.

Then there are the doctors themselves. They speak compassionately with agonized mothers and fathers who are saying hello and goodbye to their babies at the same time. These babies have names, and some will have funerals. (The late abortion procedure described in the film is to stop a fetal heart by chemical injection and then over a period of days cause the natural birth of a stillborn child.) For other women who never intended to get pregnant, the doctors focus on helping them work through their thoughts and feelings so they emerge on the other side of the abortion in the best possible emotional place and physically able to bear future children.

Dr. Warren Hern describes his motivation for doing this work:

When I was in medical school, I loved delivering babies. I thought it was wonderful … I loved doing that. And then, when I was a Peace Corps physician in Brazil, there was one ward full of women recovering from childbirth, and there were two wards full of women recovering from illegal abortion. About 40 or 50 percent of the women who had had illegal abortions died. And then when I was on pediatrics we took care of children, babies — they were abused; they were battered. And these babies would come in and be hopelessly damaged. Brain damage and terribly injured. Because the parents didn’t want them or they were not prepared to be parents … There was a stark contrast between the women who were having babies they wanted and ready to care for them and the women who, for one reason or other, were not going to take care of their babies and continue with that. So, I’ve looked at this from the beginning as a public health issue.

Dr. Susan Robinson talks with a 16-year-old woman at 25 weeks’ gestation, who hates herself, who is mad at herself that she let this happen, is Catholic, was pro-life, whose entire family wants her to keep the baby, who would never walk away from or put her baby up for adoption — and still is committed not to have the baby. Dr. Robinson then explains why abortion has to be a woman’s choice:

Women come here having decided that this is not a pregnancy that they can or want to sustain. Where does it come from that I get to say, “Oh, yeah? Well, why? Why? Why do you want an abortion? You explain to me, justify it to me.” Why is that fair? What if you’re just not a good storyteller? Why would it be OK for me to say, “No, you’ve gotta tell me a better story than that?” Because what I believe is that women are able to struggle with complex ethical issues and arrive at the right decision for themselves and their families. They are the world’s expert on their own lives. So if somebody comes in and she says “I want an abortion,” whether or not she is articulate about it, let alone whether she has a great story to tell, isn’t the point. The point is that she has made this decision … If I’m gonna turn down a patient it should be because I think it’s not safe to take care of her. I think that’s really the only reason that it’s fair to turn a patient down.

Dr. Shelley Sella shares her perspective on doing late abortions:

I think for some providers what’s difficult about the third-trimester abortion — and not just providers — is that the woman delivers a baby. And it’s a stillborn. And that’s hard to deal with … I think the reason I’ve struggled is because I think of them as babies. I don’t think of that as a fetus. To me, I think of that as a way to distance myself from what I do. I mean, it’s one thing when it’s a first-trimester abortion and what you see is a little bit of tissue. But if you go all the way to the other extreme you can’t say that’s some tissue. That’s not tissue. It’s a baby. Then you have to think about it. What are you doing? And why are you doing it? Well, it’s inside the mother. And she can’t handle it for many, many extremely desperate reasons. What drives women to seek a third-trimester abortion? The less people understand what’s going on for the woman it’s impossible to support it. How could you, really? I mean, it sounds barbaric, doesn’t it?

Dr. Leroy Carhart opened a clinic in Maryland after he left Nebraska when it passed a 20-week abortion ban. When activists threatened the landlord of the clinic property and picketed his daughter’s school, the landlord refused to shut down the clinic. Dr. Carhart reflects, saying:

And I think if we don’t fight back, it’ll go away, that abortion will not be available … Things have changed since Dr. Tiller’s death. And it’s a shame that George had to die to get that started, but I think indeed, he did get a lot of the dialogue started that’s going on today.

The film does not try to present both sides of the abortion debate. In a companion guide to the film, the producers explain their choice this way:

Our agenda is not political, but humanist, and we hope that no matter where audiences stand on the question of legal abortion, After Tiller will lead them to look at it in a new way. People with a range of opinions on abortion will have the opportunity to consider the perspectives and circumstances of women they may have never heard from or thought about. The film provokes audiences to think about whether or not they can accept other people who make decisions they may disagree with. How do we judge the life circumstances of others? … We hope our filmmaking will help people evaluate their positions in a more honest, thoughtful, and complicated way.

The film is widely available (e.g., via Netflix Streaming or Amazon). You can also find more information about this documentary on Facebook.