New documentary profiles the four U.S. doctors who still perform third-trimester abortions

A new documentary called “After Tiller” explores the lives and motivations of the four doctors who still perform third-trimester abortions in America.

The doctors were colleagues of George Tiller, a late-term abortion doctor who was shot dead in 2009 by an anti-abortion activist while serving as an usher at his Wichita, Kan., church. Tiller’s clinic had been firebombed in the 1980s, and he had survived multiple gunshot wounds from an attack by an anti-abortion activist in 1993.

The film, which will be released in New York City on Sept. 20, examines what makes these four physicians choose to perform a controversial procedure that only 10 percent of Americans think should be legal in the first place, placing them in the middle of a virulent political debate that leaves them in constant fear for their lives.

The Supreme Court has ruled that states may not place an undue burden on a woman’s right to obtain an abortion up to the point that a fetus is viable outside the womb, which happens around when the third trimester begins. A that point, states may ban abortions as long as they make exceptions for when the physical and mental health of the pregnant woman is at risk. Only nine states allow third-trimester abortions without restrictions. (Third-trimester abortions make up less than 1 percent of all abortions performed each year, according to the Guttmacher Institute, an abortion-rights think tank.)

Walter Hern, a septuagenarian doctor whose abortion clinic is in Boulder, Colo., sleeps with a rifle by his bed and has received countless death threats.

“Many, many times I felt so alone,” he says sadly in the documentary. (Hern’s elderly mother, who makes a brief appearance in the film, has also been threatened.)

LeRoy Carhart, a Nebraska abortion doctor, says his barn was burned down by anti-abortion protesters, killing his horses. He’s shown in his spare time scrolling through websites that paint him as the Antichrist.

Susan Robinson and Shelley Sella, two jolly California doctors who take turns commuting to their abortion clinic in Albuquerque, N.M., have also seen their share of threats. Robinson keeps the numbers of federal marshals and other law enforcement officers taped up in her remote home.

The doctors agreed to participate in the film despite the increased exposure — and potential risk — because they wanted to explain why some women seek abortions late in pregnancy, filmmaker Lana Wilson said. Tiller, their mentor, rarely gave interviews.

“All the doctors made a decision that it's easier to vilify them when people don’t know very much about their stories,” said Martha Shane, Wilson’s co-filmmaker.

Wilson and Shane decided to make the film after reading the news coverage of Tiller’s death. Wilson said she became “obsessed” with wondering why anyone would do a job that required him to travel to work in an armored car, survive multiple gunshot wounds and become the target of hatred around the country and world. The murder trial of Kermit Gosnell, a Philadelphia doctor who was illegally delivering and then killing babies in his unregulated clinic, has reignited the debate over late-term abortions in the country. (The doctors featured in this film say they are horrified by Gosnell, according to the filmmakers.) And many who oppose late-term abortions say there's no valid excuse for intentionally ending the life of a baby that late in a pregnancy and that the procedure is essentially state-sanctioned murder.

“They are fundamentally very happy people,” Wilson said of the four doctors. “They have incredibly strong supportive families, happy marriages. Most of them have kids. And their families are completely behind them. I don't think they could do this work without their families.”

“After Tiller” challenges viewers to grapple with the problem each pregnant woman faces. In one of the earliest scenes, two couples — faces hidden from the camera — explain to Sella why they want to abort their babies. One woman, choking back tears, says fetal testing revealed her baby might not be able to walk or eat on her own, because of a congenital joint disorder. The other pregnant woman in the room explained that testing showed that her baby would be born without part of its brain.

“We’ve prayed,” the woman’s husband says. “I said, ‘If I’m not supposed to be here give me a sign right now and I will get up and leave.’ I want my child to have as good a chance as anybody. ... This is not per se ‘the right thing’ as some people would view it, but I think in the end it’s best for the baby not to bring them into the hard world like that.”

His wife chimed in, “They will be angels in heaven.”

Other women seeking abortions in the film had healthy pregnancies but were in denial that they were pregnant until it was too late or had trouble accessing abortion providers in their towns or cities when they were earlier along in their pregnancies. Some just didn’t make the decision to terminate until they were far along and didn’t necessarily have heart-wrenching circumstances to explain their desire to abort a viable fetus.

Robinson talks about struggling with her role as final judge of whether someone should receive a late-term abortion, because women are unable to ask other doctors for the procedure. “She's just too far along, I can't help her,” she decides in one case, of a woman who has been pregnant for 35 weeks. (Most women deliver at 39 weeks.) The doctors explain that they will perform a late-term abortion as long as it's safe for the patient, regardless of her reason for seeking it.

Wilson said the film does not try to answer the question of whether third-trimester abortions are morally or ethically acceptable, but rather it challenges viewers’ assumptions about a topic that is argued about but rarely experienced firsthand. The film also avoids the debate over whether it's ethical to end a pregnancy because a baby would be disabled, a practice that some ethicists compare to eugenics. “We're not trying to resolve the questions of if they're babies or if they're fetuses or when does life begin,” Wilson said.

The doctors admit in the film to struggling with the morality of their jobs.

“I think about what I do all the time, and I recognize what I do,” Sella says. “And at times I struggle and at times I don’t. But I always come back to the woman and what she’s going through.” Later in the film, Sella says she believes that when she performs an abortion, she is ending the life of a baby, not a fetus. “I think the reason I've struggled is because I think of them as babies,” she says. “I don't think of them as fetuses.”

Wilson says she hopes that the documentary will force people in both “warring camps” on the abortion issue to confront actual individual circumstances — the woman pregnant with a baby without a brain or the 16-year-old who couldn’t figure out how to access an abortion earlier in her pregnancy — and reassess their positions.

“It really gave me a better sense of just how difficult women's lives are in this country and how easy it is to forget that or blame people for ending up in a certain situation,” Shane said.