PARK CITY, Utah – The Sundance Film Festival has a relaxed, down-to-earth vibe, but the atmosphere at the premiere screening of the documentary "After Tiller" was noticeably tense.
For starters, police and armed sheriffs in green jumpsuits made a show of force outside the Temple Theater. Attendees had to have their bags searched and were checked by guards with hand-held metal detectors. After the movie screened, two police officers stood at the front of the auditorium as the directors of the abortion documentary — and the four doctors featured in the film — answered questions from the audience.
"After Tiller" is an intimate and heartfelt look at the four doctors who legally perform third-trimester abortions in the United States, doing so even after the 2009 assassination of such a physician, Dr. George Tiller. Directed by Martha Shane and Lana Wilson, who spent almost three years on the project, the film brings an emotional sensitivity to an issue in which every nuanced turn of phrase has been made politically complicated.
"The four doctors really are proud of what they do," Shane said in an interview the day before Friday's premiere. "They don't feel they are working in the shadows. They're brave enough to let the world know they do third-trimester abortions, they are public about it. I think part of the reason they agreed to participate in this film was actually to show that they are proud of the work that they do, it helps women and alleviates suffering."
Late abortions make up less than 1% of all abortions performed in the United States, yet they are a frequent part of the debate over abortion rights. Small discoveries like that drew the duo to the subject.
"I feel like our generation has been really alienated from the abortion debate," said Wilson, who like Shane is 29 and was born after the 1973 Roe vs. Wade case. "It's just become a shouting match. We wanted to make something that would show the complexity and the gray area. The gray area over this issue is where real women are making real decisions about their lives."
Having spent some four to six weeks with each doctor — looking to craft individual portraits to provide a sense of their unique stories as well as the larger issues they all face — the filmmakers realized that showing the doctors with their patients was crucial to understanding why they do what they do.
Patients' faces are not shown on camera, but viewers hear their stories. The women turn to these late-term procedures for personal and medical reasons, including fetal anomalies, the health of the women, and sometimes because the women don't even realize or admit to themselves that they are pregnant.
For many of these patients, and their male partners, the decision is an agonizing one. And the doctors themselves frequently discuss moral questions themselves.
"We set out to make a film about the doctors but as we started, it became really clear that the best way to get to know the doctors was through filming them with their patients," said Shane. "That's where you really see how empathetic they are toward what these women are going through and the sort of medical care they provide. They really are experts in their field and provide amazing care by any standard.
"The reason why they want to do this work is to help these women. So you need to understand the stories of the women they are helping in order to understand why they want to do this every day and risk their lives to do it."
Even in the face of threats and the killing of Tiller, the doctors see their work as important and worth continuing. They voice concern about what desperate measures women might take if their services were unavailable. As to whether the protests against what he does ever gave him doubts regarding his work, Dr. LeRoy Carhart said, "I never even give it a second thought."
As to why the doctors agreed to participate, Dr. Susan Robinson said: "Abortion in general, particularly third-trimester abortion, is so stigmatized and cloaked in secrecy and shame it's just appalling. And we were happy to be putting some sort of human face to this that people would realize most people in abortion care are not gruesome characters, they are people with plenty of options to do other things.
"We do it because we know that people desperately need it," Robinson added, "and we find it satisfying in that we get to help every woman that walks through the door."
The protest movement against abortion is kept in the background of the film, a low-level hum that is always present but never given center stage except during such moments as when Carhart has to move part of his practice from Nebraska to Maryland due to changes in state law. He now travels among three states offering his services.
"We tried to frame it as clearly as possible as being a part of these doctors and seeing it from their point of view," said Wilson, "and for them, the protesters are there kind of buzzing in the background all the time, but they are not a big presence in their lives, other than a possible threat lurking there. I think we wanted to represent the protesters in a way that was true to the doctors' experiences of them, but we also didn't want to make them look crazy or one-dimensional. Even though they are a small part of the doctors' lives, we tried to treat them fairly when they are in the film."
"I think one of our goals as filmmakers was not to make an issue movie," added Wilson, "not tell people what to think but just give people the space to start asking questions. We want to spark a conversation on this subject and we want people to feel comfortable asking questions."
Staff writer Julie Makinen contributed to this report.
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