‘After Tiller’

‘After Tiller’ Profiles Last Four U.S. Doctors Who Do Late-Term Abortions

After Tiller, the Sundance documentary named after the physician gunned down in 2009, follows the four doctors in America who still perform third-trimester abortions. Marlow Stern speaks with three of the doctors about the abortion battle, and their fanatical foes.

We’re 40 years after Roe v. Wade, and the women in America are in worse shape than they were 40 years ago. Their rights are being trampled in the street.

These are the words of Dr. LeRoy Carhart. A former lieutenant colonel in the U.S. Air Force, Carhart is one of only four doctors in the entire country who publicly perform late-term abortions, loosely defined as those in the third trimester of pregnancy (25 weeks) and beyond.

Carhart, along with Dr. Susan Robinson and Dr. Shelley Sella, were protégés of Dr. George Tiller—a late-term abortion provider who was shot in the head and killed by an anti-abortion activist in 2009 while serving as an usher during Sunday morning mass in Wichita, Kansas. He was the eighth abortion provider to be murdered in the wake of Roe v. Wade. This trio, along with Dr. Warren Hern, a contemporary of Tiller’s who has been performing abortions since 1973 and was even present during the arguing of Roe v. Wade before the U.S. Supreme Court, are the subjects of Martha Shane and Lana Wilson’s After Tiller, a controversial documentary that premiered at the 2013 Sundance Film Festival.

The film seeks to humanize these four pariahs of the medical profession.

“I had the privilege of being present when Sarah Weddington argued Roe v. Wade in front of the Supreme Court,” Dr. Hern told The Daily Beast. “But it was a time when there was a reasonable middle. The Republican Party was not the captive of the most vicious fanatics in the country like they are now. The community climate set by the politics, which is increasingly vicious and stupid, has a profound effect on what we do. When abortion doctors are assassinated, the political right has celebrated those assassinations. It’s a very serious and dark matter in American society.”

Indeed, the abortion issue reared its ugly head during the recent U.S. election season. There was Rep. Todd Akin, who claimed women do not get pregnant from rape, and that their bodies have a magical way of rejecting rapist semen. “If it’s a legitimate rape, the female body has ways to try to shut that whole thing down,” he infamously said. Or vice presidential hopeful Paul Ryan (R-Wis.), who is fervently anti-abortion, even in cases of rape and incest. Just yesterday, Gov. Rick Perry (R-Tex.) told lawmakers he’d like “to make abortion at any stage a thing of the past,” and one particularly kooky anti-abortion crusader scaled a large tree and attempted to disrupt President Obama’s inauguration ceremony.

Dr. Carhart believes these anti-abortion crusaders are part of a larger plan concocted by the Republican Party to make women and minorities second-class citizens.

“If all abortions become completely illegal in the United States, then women can’t compete in the marketplace so corporate America becomes all-male—and unfortunately would become all white male, since minorities are the ones who need abortions and can’t pay for them,” he says. “Rich, white people can go find one. This whole thing is a conspiracy, as far as I’m concerned, to keep the WASPs in power.”

After Tiller is largely devoid of politicking, instead choosing to simply follow the four doctors about their business. Throughout the film, the foursome counsel women seeking late-term abortions for reasons ranging from rape to life-threatening birth defects. Historically, between 10 and 20 percent of late-term-abortion patients seek the procedure due to serious fetal abnormalities or medical issues, according to Dr. Hern, and more recently, that number has climbed to as high as 50 percent.

And the doctors come off as remarkably patient and understanding people who take a vested interest in their patients.

“The average time that people speak to their doctors when they go to a general practitioner before being interrupted is eight seconds,” said co-director Shane. “These women speak to these doctors for hours and they’re unbelievably good listeners. This should be a model for all medical care in this country.”

One of the most intense scenes in the film involves Dr. Robinson. She receives a call from France. The woman is frantic. She is 35 weeks pregnant and seeking a late-term abortion due to the unborn child’s life-crippling birth defects. But Dr. Robinson is forced to turn her down, explaining that although there is “no legal cut-off date” in the states that these four practice—Maryland, Colorado, and New Mexico, currently—they’ll accept a patient only if they’re confident they can complete the procedure. At another point in the film, Dr. Sella even confesses that they are indeed aborting babies that have been brought to term. The other three doctors see things a bit differently.

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“Nobody has the right to determine when it’s a baby other than the mother of that child,” said Dr. Carhart.

Adds Dr. Hern: “It’s an issue of medical judgment and should solely be an issue of medical judgment between the physician and the medical community. And it’s unresolved in the medical community.”

The film also seeks to demystify the late-term-abortion procedure that, according to Dr. Robinson, is far safer than having a baby.

“The major complication rate of giving birth vaginally in this country is 30 percent because unintended surgery is considered a major complication,” said Dr. Robinson. “My major complication rate doing late abortions is 0.6 percent.”

While the doctors in the film have partners, they still lead very solitary lives. Dr. Carhart is forced to pack up his family and move to Maryland after Nebraska, where he had been practicing for years, modified its stance on late-term abortions. And, in addition to the ubiquitous protesters outside their various medical establishments, the doctors have come under personal attack on a number of occasions. Eighteen of Dr. Carhart’s horses were killed when anti-abortion fanatics, in an act of vengeance, burned down his stables. Dr. Hern has had people shoot through his office door and threaten the life of his very elderly mother.

“Doctors want status and this is the most stigmatized, lowest-status activity in the medical profession—well below the guys who do insurance-physical exams,” said Dr. Hern. “No reasonable person would do what we have done. For me, it’s a great privilege to do this work, and we’re at a very critical point in history. Will we go back, or go forward?”