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Conscience Magazine

After Tiller: Is Anybody Out There Listening?

By Ruth Riddick February 19, 2014

Sometimes life just trumps fiction. Had young filmmakers Martha Shane and Lana Wilson approached Central Casting for After Tiller, their film project about late-term abortion providers under siege, they could hardly have assembled such a boiler plate cast: two men and two women—one radical with a 1960s Peace Corps background, one Republican horse farmer, one articulate lesbian, one grandmotherly type. True, all four will never see their 50th birthday again and they’re all white. But you can’t have everything….

And Shane and Wilson’s film is full of things we apparently can’t have. Where in the US are the young doctors from differing backgrounds and traditions willing and able to serve communities desperate for still-legal services? Where is the peace of mind for providers suffering daily harassment from zealots who have no care for women or the law? Perhaps most important of all, where is the political movement offering meaningful support and advocacy for abortion providers and the care they provide? (Although After Tiller carefully doesn’t say it, the film suggests that the prochoice movement has hung these doctors out to dry.)

Nor can we attend a screening of this documentary without being subjected to a “security check” occasioned by concern for the filmmakers’ safety. Do you expect your bag to be searched when you enter a movie theater? To be frisked? Didn’t Benjamin Franklin caution against giving up freedom for security for surely we will lose both? Welcome to the very latest frontier in the abortion wars: an art house cinema in deepest liberal Manhattan.

“The idea for After Tiller came from our frustration with coverage of the assassination of Dr. George Tiller in May 2009,” Lana Wilson told Conscience. “The story was treated as controversial because of the abortion angle, with the media afraid of seeming biased if they gave any more information about Dr. Tiller beyond a basic bio.” With a reporter’s instinct, Wilson became interested in how a deeply religious person like Tiller could become such a target for a fanatic that he was gunned down in church. “He had been shot before,” Wilson reminded us. “He went back to work providing abortions the next day. Who does that? Most people in the community don’t. What motivates a person like that?”

Born in 1941, George Richard Tiller became nationally known in his thirties as medical director of Women’s Health Care Services in Kansas, one of very few  nationwide to provide legal later abortions during his tenure there (1975–2009). The practice was originally his father’s, and he took it over only after learning the story of a woman who had recently died from an illegal abortion.

After Tiller Poster Art(Although we no longer hear much from them, doctors often become advocates for legal abortion from a conviction that allowing women to die in the backalleys is unethical. This voice is integral to abortion law reform and most successful when aligned with an assertive prochoice movement. Is such a coalition at work in the present political landscape? If so, it’s hard to discern.)

Dr. Tiller focused on providing abortions for women who discovered severe or fatal birth defects late in pregnancy. He also offered legal later terminations where two doctors certified that carrying the fetus to term would cause the woman “substantial and irreversible impairment of a major bodily function.” In other words, George Tiller worked to save women’s lives.

A lightning rod for militant activists, Tiller’s clinic was firebombed in the mid-1980s and picketed daily for a period of five years prior to his murder. Tiller himself was shot in both arms in the early 1990s before being fatally injured while serving as an usher at the Reformation Lutheran Church in his native Wichita.

The murderer, now serving a life sentence, is reportedly a troubled antichoice activist with a history of mental illness. Scott Roeder was careful to shoot Dr. Tiller in the eye, thereby avoiding the body armor that his victim had worn constantly since being advised to do so by the FBI a decade earlier. In his prison confession, Roeder stated that he felt no remorse for the killing.

As wilson could no longer ask Dr. Tiller about his unwavering motivation, she and Shane went in search of other doctors continuing to provide these services. “We asked ourselves: were there any doctors left, or were they all scared away?” They found four of Tiller’s colleagues and friends. The two men were immediately willing to be interviewed. The women, however, were shy of the media disdained by Tiller, who believed that publicity for service providers distracted from the needs and stories of the women who come for their help. A year into the project, they finally came on board, trusting the filmmakers not to sensationalize or exploit their work.

The four doctors who appear in After Tiller are Dr. LeRoy Carhart, Dr. Warren Hern, Dr. Susan Robinson and Dr. Shelley Sella (see panel). Professionals offering lawful services, they live and work in the shadow of the Tiller assassination and face constant disruption and threats of violence. That Tiller’s fate hangs over each of them is most poignant for Robinson and Sella, who worked with him in Wichita and were displaced by the murder. All share an everyday heroism: they do not surrender to fear.

To spend time with these men and women, as we do in the course of this feature-length documentary, is to enter the surreal. Whether sitting at a desk, walking the countryside or showing a prized horse, the doctors are plainspoken and seem accepting of their bizarre circumstances. Only Warren Hern directly addresses any political issues, dating the abortion wars from the 1970s. He would sound jaded but for his personal happiness. To the viewer, it’s inconceivable that his love story could emerge, much less thrive, in such a chronically challenged life. But what do we know?

This is another question After Tiller addresses head on: what do we know of later abortion? We meet some of the patients and hear their stories even as we marvel at how closely the doctors listen and watch how deep their compassion reaches. “The reason so many patients agreed to participate in the film is because they never thought they would end up in such a desperate situation and saw sharing their stories as the only way anyone could possibly understand,” Shane explained.

Some of the clinical scenes are unbearably moving as we come to realize that, for the women and their families, these doctors are the last refuge in grotesque crises. We watch the dreadful decision–making process as clinicians struggle to reconcile anguish with options, desperation with the law—all to the off-stage noise of an antichoice protest that may at any time turn murderous.


Image of antiabortion protestors in a scene from Martha Shane and Lana Wilson’s After Tiller.
Antiabortion protestors in a scene from Martha Shane and Lana Wilson’s After Tiller.

“Our goal was to humanize the story,” Wilson insisted. In general, the critical response to After Tiller suggests that the filmmakers have been successful, and the film itself was nominated for a Grand Jury Prize at the 2013 Sundance Film Festival.

Sara Stewart wrote in the New York Post: “After Tiller is groundbreaking in giving voice not only to the doctors, but to those who always seem to get overlooked in the high-volume political debate about this topic: the women themselves.” In the Austin Chronicle, Kimberley Jones added that the women interviewed “explain why they’ve chosen to terminate their pregnancies in the third trimester—one is motivated by dire economic straits, another doesn’t want to carry to term the product of a rape, while several cite lethal fetal conditions.”

It has become a truism of public debate that women are silent about their abortions. Yet, to a great extent, it’s more accurate to say that we aren’t hearing them. Women have been bearing witness to personal abortion experiences since before Roe v. Wade, and there’s still a generation alive willing to talk about what it was like in the backalleys. In the intervening years, countless writers have found ways of accompanying women across state lines, into counseling services and as far as operating rooms in order to capture and broadcast their stories. In this respect, After Tiller is simply the latest telling. So, the question for the film’s audience, as for the prochoice movement, becomes, “Is anybody out there listening?”

“As documentary filmmakers, we’re interested in different points of view and we want to portray that,” said Martha Shane. With an optimism appropriate to their age and advantages, the filmmakers plan to tour the country raising consciousness at screenings in as wide a range of venues as possible. “I really hope that antichoice people come to see the film, hear the women and get to know the doctors,” Shane continued, recalling how she engaged amicably with clinic protesters during filming.

Photo of After Tiller directors Martha Shane (L) and Lana Wilson.
After Tiller directors Martha Shane (L) and Lana Wilson.

Veteran film critic AO Scott dismissed her as naïve. “It would be nice to believe that a movie like this could provoke civil and respectful dialogue about an intensely polarizing issue,” he wrote in a New York Times review. “But let’s not kid ourselves.” Scott bluntly labelled the film “a partisan document in the culture wars.”

Of course, Wilson and Shane do describe themselves as having been prochoice when they began the project, and the partisan charge has some merit. The experience of producing After Tiller, however, has added nuance to their position. “I started out more judgmental,” Wilson now admits. “I took my privileges for granted, which I didn’t understand until I met the doctors and heard the stories.” In common with many of their peers, Wilson and Shane also acknowledge that they didn’t know much about third-trimester abortion. “The prochoice movement has some discomfort about late abortion,” Shane explains, confirming that she now has a much clearer idea of the complexities involved. “I think that my sense of compassion for those patients and what they’re going through increased exponentially because of this experience,” adds Wilson. “And I think I’ve become a less judgmental person in general as a result.”

“Our agenda is not political, but humanist, and we hope that no matter where audiences stand on this issue, After Tiller will lead them to look at it in a very different way,” Shane stated. “We hope that our filmmaking will help people evaluate their positions in a more honest, thoughtful and complicated way.”

There’s an issue haunting After Tiller: where is the generation represented by Shane and Wilson? When Carhart, Hern, Robinson and Sella hang up their stethoscopes, who will be left? The women who need these services, certainly, but who will be there to help them? Who will perform the legal abortions nobody wants to publicly support? To listen to the women who aren’t otherwise being heard? To support doctors and patients politically?

If After Tiller inspires young doctors and advocates to enter the field, it will have succeeded in a mission Wilson and Shane never knew they had in a generation yet to prove itself. It would be a worthy outcome for their efforts.

Ruth Riddick
Ruth Riddick

led a successful appeal at the European Court of Human Rights against Ireland's restriction on information about extra-territorial legal abortion (Open Door Counselling, 1992), resulting in Irish constitutional and legal reform. Her polemic on "women's right to choose" is featured in the Field Day Anthology of Irish Writing. She is a regular contributor to Conscience, usually writing on film and the arts.

Tagged Abortion