Directors Lana Wilson & Martha Shane and Dr. Susan Robinson on the Importance of ‘After Tiller’

Abstaining from the harsh, political bent of most documentaries focused on the subject of abortion, Lana Wilson and Martha Shane’s After Tiller takes a tremendously emotional and controversial subject and endows it with warmth and humility. Providing an illuminating and wholly important look at the power of personal choice, the film leaves the floor open for discussion—both giving insight into the intricacies of late-term abortion and the incredibly challenging lives of those who provide them. Dr. George Tiller, the leading physician to provide third-trimester abortions, as well as a strongly religious and loving family man, was assassinated in his church in 2009 by a pro-life extremist. And it’s in the wake of the tragedy of his death, where After Tiller picks up.

Focusing on the four doctors across the country that still provide these services to women in crisis across the world—Susan Robinson, LeRoy Carhart, Warren Hern, and Shelley Sella—the film gives us personal look into the day-to-day lives of these doctors, allowing them a stage to voice their opinions and knowledge, while giving a compelling look at the exceptional challenegs the women who seek their care must face. And after feeling both confused and shocked when learning about Dr. Tiller’s death, and seeing the way in which the news coverage of the tragedy failed to focus on who he was as a person, Wilson and Shane set out to make a feature that examined the intimate details of these physicians who are at the center of a debate that continues to rage on. And as an extremely moving portrait with unprecedented access into these clinics, through the lens of After Tiller, we bear witness to first-hand accounts of the women undergoing these abortions, the reasons why they’ve made their decision, and the immense weight of that on their lives.

Last week, I sat down with Wilson and Shane, as well as Dr. Susan Robinson to discuss what compelled them to make this film, examining the subject with tenderness, and just who has the right to tell a woman what to do with her body.
Can you two tell me how you decided to make this film and tackle such a heavy topic such as this? As two people who aren’t activists yourself, what compelled you to pursue this?
Lana Wilson: I was actually film curator before this for this arts festival called Peroforma, so I wasn’t a filmmaker. But I just became obsessed with the idea after Dr. Tiller’s assassination. I was following it closely on the news and I remember thinking, Wow this guy was a deeply religious Christian—he was killed in the church he’d been going to for decades with his family—and I thought that was really surprising that he could be the number one target of the antiabortion movement, but he was a deeply religious Christian. I’d also learned that he’d been shot once before in the 1990s and he’d gone back to work the next day, so that made me wonder who would do that and why and what would motivate someone to have such dedication under the face of such siege everyday just going to work? I was feeling very frustrated and curious that the news coverage wasn’t really answering any of the questions I had about who this guy was personally. The news was doing the same kind of thing that they always do when abortion is covered: here’s the talking point from this side and here’s the talking point from that side. And that was it. So I thought it would be great to have a more personal, humanistic look at this and at first I thought it would be great to do a documentary about Dr. Tiller, but then I thought, wouldn’t it be cool to be a fly on the wall in the lives of whose doing this work after Dr. Tiller? I wondered if there were present day doctors who are going to keep doing this, will they be scared away and what’s going to happen. So that’s where it came from. I just thought someone had to make a movie about this, so I’ll make a movie about this. And luckily, I had this dear friend who had been making documentaries and knew what she was doing, so I asked her if she would collaborate with me on it. We went to college together and both studied film there.
Martha Shane: When I heard the idea and heard that there were only four doctors who were openly doing these later abortions, I was just shocked. It made me really curious about what their lives are like, why women would come to them, and why someone would need an abortion in the third trimester. I really wanted to make a film that was going to be less political and more focused on the intimate lives of the doctors and the patients who they take care of.
Dr. Robinson, what was your initial reaction to being asked to be a part of the film?
Dr. Susan Robinson: [makes an X with her fingers] No way. I remember one time I was at my desk painting—I’m trying to learn to do watercolors—and Lana called, and I had the phone and I was explaining why I was absolutely not interested in doing this film, and that was because Shelly Sulla she and I worked for Dr. Tiller. He would nerve talk to anybody in the press ever, and he said, “It’s not about me, it’s about the patient,” and that’s how we were brought up. That’s what we thought was the correct response; we didn’t really think of an alternate response. We were little Dr. Tiller clones pretty much—not so much anymore, but he ran a tight ship there and we toed his line. So Lana called first and she was very nice and I kept saying I’m really sorry but this is not the kind of thing I do. And Lana would say, “Yes, but…,” and I would say, “No, but…,” and it went on like that for quite a while. So I thought that was the end of the story. But then Lana and Martha asked if they could come out to visit our clinic. So one of the clinic owners—she’s a psychologist and she’s in charge of the counseling side— the four of us went out to dinner, and we were both so taken with Lana and Martha and how on the ball they were that suddenly the whole picture changed. It was really good that you guys did that because that’s what swung it for us! And then this Kermit Gosnell business started—the guy who was delivering live babies and killing them—so Shelly and I thought, if we say no to this film, Kermit Gosnell is going to be the face of later abortion. And the guy looks like a complete creep and a sleaze and we thought, if we don’t talk about it, nobody’s ever going to understand why this is necessary or a good thing. So it was a combination of meeting Martha and Lana and then Kermit gave us the last push over the cliff. 
Did all four of you agree together to be a part of the documentary?
SR: No, the guys were happy to do it right off the bat.
Why do you think that was?
SR: They were not as much cast in the Dr. Tiller mold as much as we were. We both had a relationship with him that was almost like father and daughter. If he said this was the right way to be, that’s the way we tried to be. Even though he was my age we had a mentor relationship. So Lee did not have that same relationship with him and Warren marches to his own drummer at all times and he has always liked opportunities to explain what he’s doing. 
LW: They’ve both have done more press in general; they would typically be game for interviews on news networks.
SR: And we had just always learned that the correct answer was, “No I’m sorry, it’s not about me, it’s about the patient.” We didn’t really evaluate that and what a silly position it was. It was right for Dr. Tiller because his energies really had to be focused on what he was doing. There was so much outside static and people outside screaming; you’d sit in his office and hear people screaming and blowing rams horns and on their megaphones. He just had to really stay focused; he couldn’t give his energy to other things. But that’s not true for us.
Yes, it’s understandably about the women but what’s so important about this film is that you’re the authority on later abortion and how is anyone supposed to understand that world fully unless we’re informed by the people who provide these services? Even myself watching it, there was so much I didn’t realize about the process. Once you had the doctors in place, how did you go about filming inside the clinics and gaining the trust of these women?
LW: It was actually good having these conversations with the doctors because we realized that they are a vehicle for getting to these patients and the way of framing all these patients in the film—especially once we started shooting in Albuquerque. We realized how important the patients story would be and they would really be front and center in the film. And to do that, they have such a wonderful team there and they were all supportive of the film, and they knew to explain to patients when they first came in that there was a camera in the clinic and we were not going to film them unless they want to be filmed. We had them talk specifically when they first sat down with the third trimester patients to say, if you’re interested in telling your story these are these filmmakers who are trying to explain why women seek third trimester abortions. Most patients said no of course, because they’re going through this incredibly challenging emotional experience anyway, but I think the ones that did agree said yes because they never expected to be here in the first place and they’re having to explain to people what’s happened with their pregnancy. I think they know better than anyone that the only way you can understand why a woman would seek a third trimester abortion is to hear these personal stories. So it was amazing, the few who did agree, would understand that because they lived through that experience themselves, walking past protestors outside the clinic, having an abortion, making this difficult decision and then going back to their community and having to explain what happened. So it was really generous and brave of them to tell their stories with us. We were a similar age to a lot of the patients and we were young women and I think that made them feel more comfortable. One person said that it was like having a couple more friends around. We noticed that, especially with the women who came there alone without a partner, they were the most likely to agree to let us film with them because they didn’t have anyone else. Although they always have a counselor that’s with them the entire time. 
SR: Oh, did somebody really say it’s like having an extra friend?
LW: Yeah.
SR: That’s so darling. It’s funny, people leave the clinic saying, “I’ve never felt so surrounded by approval ever in my life.” And in fact, I’ve had people cry when they leave, saying, “I don’t want to leave,” because everybody’s on their side and focused on making them get through this with as little agony as possible. I’m their Nana.
And for something that is so incredibly personal and takes place inside your own body you’re subject to a terrible amount of judgement and of course, this is a place where you’ll never be judged.
SR: Yes, no one judges you. And people say, “Thank you so much for not judging me.” And we’re like, this is an abortion clinic, what did you think was going to happen?
As a doctor, were you ever worried about patients feeling like their confidence was breached by having cameras around?
SR: No, never. It was explained to them before they ever saw the cameras—if they didn’t want to see the cameras, they didn’t have to. Martha, Lana, and the cinematographer—I don’t know how they did this—but they melted into the woodwork despite the fact that they had a great big camera and a boom mic and all that. They just were very unobstrusive and they all looked friendly. The cinematographer was a woman too, and pretty soon it did seem like there were just more people around that were friendly.
How much time did you spend in each clinic?
LW: It was about four weeks in each clinic.
MS: And from the beginning we knew we wanted to get a female cinematographer because just being in the rooms with the patients, we felt like people would be more comfortable. It was funny because it actually caused a controversy. I posted an add on this documentary list serve saying that I was looking for a female cinematographer, but I didn’t explain the project at that point. People started saying, “Oh why do you want a female cinematographer? You can’t ask for a a white cinematographer or a black cinematographer, that’s not acceptable!” So it was interesting to see. I don’t think there’s a lack of opportunities for male cinematographers, but it was just amazing, the cinematographers we worked with were so patient. And we said from the beginning we want this to be opposite of reality TV where the camera is moving all over and following everyone. They really got that and were like rocks on our shoots.
In explaining the film to other people, it sounds strange to them to hear me say how tender and compassionate the film felt because this is such a painful subject matter and the other films that have dealt with abortion tend be much more harsh. Did you want to capture the gentleness and human aspect from the very outset and that would be something to differentiate this?
LW: Absolutely, yeah. What you’re describing almost sounds like Lake of Fire—which is literally in black and white. There’s a lot of interesting stuff in that documentary, but it’s people having these abstract philosophical arguments about abortion. I feel like one of the things I learned from filming in the clinics very quickly, was that a lot of these philosophical arguments you have about abortions, they tend to drive people to extremes first of all, because they’re abstract. But also, those kind of debates have so little do with what the women who come to these clinics are actually facing when they’re in these much more grey situations. It’s not about having a philosophical debate about when life begins— because how can you possibly resolve that for every person when people’s beliefs on that are so varied—it’s about the life situation, the incredibly complex situation this woman is in and the set of decisions she can make. So just realizing that divorce between those kind of black and white polarizing fights and this much more nuanced, subtle reality on the ground was something we learned quickly and wanted the film to highlight.
SR: The feeling of After Tiller is different than the feeling of Lake of Fire, which is just full of hate from the beginning to the end. It’s just like “I hate you, I hate you, I hate you!”
LW: Everyone hates each other.
SR: Everyone hates each other! And in After Tiller it’s quite the opposite. I’ve never really thought about that contrast. 
There was one woman in the film who said that she was going to feel guilty no matter what, and naturally there is no right answer. So it was interesting to see how you as a doctor still have to wrestle with that question within yourself everyday.
SR: Right. So there you are, you’re pregnant and you have three choices: you can have a baby, you can give it up for adoption, or you can have an abortion. And as I inelegantly said in the movie, “They all suck.” I said, “Of course she doesn’t want an abortion, nobody wants a fucking abortion!”
LW: That’s many people’s favorite line in the movie. A line that seems obvious but—
SR: Is it still in the movie?
LW: Of course! People love that line.
SR: Oh, how funny. But yes, you have three choices and here you are, and yes, you may regret any one of them but anything you do you may regret. You could step off the curb and get hit by a truck and you’ll regret stepping off the curb—but you’ve got to do something in life other than just sitting there or you’ll regret just sitting there. 
How have the reactions been to the film from both extremes?
MS: Basically the reaction to the film has been really warm and supportive. The people who have seem the film have mostly come out saying that this film makes you realize how much more complicated this issue is than they ever realized before. It seems to make pro-choice people think about their views and question their views more thoughtfully, and also pro-life people. We’ve had a lot of anti-abortion people come up to us after screenings and say, “I didn’t realize what some of these patients were gong through or why a woman would seek a later abortion.” And on the same point, we’ve had pro-choice people come and say, “You know, that patient at the end, the sixteen year old girl, that made me really think about what it meant to be pro-choice.” It means having to support women making of their own decisions, regardless if I think it’s the right decision or not. It’s really provoked more thought and focusing less on the abstract issues surrounding abortion and more on the more intimate real life questions of how people find themselves in these situations.
SB: People who are generally pro-choice have really said, “Oh I just thought the movie was wonderful and I never really thought about the nuts and bolts of it and why people would need a later abortion.” I haven’t really talked to very much anti-choice people, but I’ve heard these comments—mainly focused around “Wow, I never understood what a complicated issue it was.” I was interviewed by another journalist who was really uncertain about how he felt about. A lot of people say they’re comfortable with abortion up to a certain extent, and then they have whatever their arbitrary limit is based on nothing, and then they say, but I’m really not comfortable with abortion further than that. So we had that discussion and he came away realizing that it wasn’t about his comfort, it’s about the patient. It always comes back to the patient and what is the patient feel that she needs to do. And who has got the right to tell her that she can’t do it? Who does have the right—is it the governor, the mayor, the legislature, the next door neighbor?
LW: There have been some really surprising connections that people have made too. One person came up to me after the screening and said, “I was anti-abortion before I saw this movie and I just adopted a child.” She’d just went through this long adoption process where she had to keep explaining herself and what she’d be providing and why she wanted a child over and over again to all these government agencies and in-personal interviews, and became so frustrated like, why do I have to justify my life choices to such a degree? And when she heard doctor Robinson talk at the end of the film about the 16-year-old and says, “Who are we to say explain yourself to me, justify yourself to me, tell me this great story,” something clicked in her. She was thinking about her own experience adopting, but realized that same process was applied to this patient.
SB: I never knew that!
LW: Yeah, and that was such an incredible response because you’re not even talking about this particular issue, but her personal experience mimicked what you were talking about and she just got it all of a sudden.
SR: And what is it about women that makes people think they’re unable to make decisions? If a guy goes and joins the Marines everyone says,”Good boy, that’s my boy,” nobody says, “Oh honey, you’re a little young, you might regret that.” I mean, women want to have a baby and people say, “Oh, you might regret that,” or if you want to have an abortion they go, “Honey, you’re a little young you might regret that.” What do they think we are and at what point are we grown ups for Christ’s sake? It makes me angry.
Dr. Robinson, you’ve been doing this work for years and are accustomed to the emotional atmosphere of the clinic but as filmmakers going into this, was it a very trying process to be there everyday?
LW: We felt like it was such a privilege for us to be there, and just dipping in for a couple weeks is nothing like doing this work for years and years. For us it was such a warm, loving atmosphere, it was a pleasure to be there. But hearing some of the stories was certainly very emotional.
MS: Yeah, we took our cue from the doctors, and it’s very clear in the film that they don’t try to put themselves at an emotional distance from the patients. So it’s okay to be emotional with the patients and if the patient is very upset, it’s okay to have your own reaction because you’re seeing them going through this tragedy and grieving with them in certain cases. We took that perspective and didn’t try to be stone-faced throughout, and if it was really emotional scene we would tear up ourselves, but also try to stay out of the way as much as possible. It was definitely a very emotional experience shooting.
Was it important for you to show the doctors outside of the clinic, in their homes and with their families, to humanize these people that are often looked at as villains?
LW: Totally. It was amazing how we were like, if you could just meet any of these four people for like 30 seconds on camera, they’re a human being and if you see them with their family, they’re a human being like you. What a difference just those little things can make. But the one thing the four of them have in common, they all have these rock solid incredibly supportive families— it’s just a really huge part of all of their lives and they’re such different people and personalities, but that’s a unanimous things. They have these incredible partners. We didn’t have a lot of time in the film, and that obviously wasn’t the primary focus, but just to get these little glimpses of that. That’s part more of Dr. Hearn’s storyline in the film because that’s about him meeting his wife and becoming a lot happier about himself and the work that he does. 
It must take a toll on you personally, having to constantly defend yourself and be mindful of your security, but to a lesser degree, there’s a point in the film when you say, “I can’t ever retire!”
SR: Right! But who am I to feel sorry for myself, Lee is a older than I am. I’m 67 and Warren in 75. My god, I’m the age George was when he was shot. But none of us can retire really because you think, oh jeez, where will everybody go? Suppose the three of us retired. But we have a new doctor now who’s 35.
Do you find there are more young people interested?
SR: Oh yes, there are young people who are interested in doing this; this is not something you just sort of stumble into, it’s like a vocation. We just finished a year of training with someone who is absolutely wonderful, and we love her. But you know, there just aren’t that many training opportunities or places for them to go. So I’m thinking now, okay, let’s take on another trainee and then I’m out. Actually, the thing I would miss the most about it is that I like being in the trenches of culture war. I enjoy that, I like thumbing my nose at the Bill O’Reilly’s of the world. And I want to keep doing that whether or not I keep doing abortion care and staying up all night is a different story.
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