In 2009, Dr. George Tiller, a religious family man, was assassinated while at his church. Some people were happy about his murder because Dr. Tiller was one of the few physicians left who performed late-term abortions. Intrigued by the story and the details omitted by the media, Lana Wilson and Martha Shane set out to make a film about the courageous doctors who practice third trimester abortion care through their eyes and through the stories of their patients.

Compelling and heartbreaking, After Tiller is an intimate exploration of the lives of these four doctors who ignore their own safety to maintain their practices. We spoke to co-directors Lana Wilson and Martha Shane about their collaborative process, what drew them to the project, and the advice they’d give to filmmakers who want to tackle a difficult subjects in their documentaries.

Tribeca: Lana, I know you had been particularly interested in the issue of abortion once you watched the news coverage of Dr. Tiller’s assassination. What about the coverage sparked your interest?

Lana Wilson: I was watching the news and started to have all these questions about who Dr. Tiller was as a person rather than as a political symbol.  He was a religious man who returned to work even after having been shot in the arms in the 1990s. He drove an armored car to work everyday. All these little facts that were in the news made me curious about him as a person.  Despite all these nuggets of information, I realized that the news was not going to go beyond his bare bones biography.

The news left out a lot of details—they were not going to say he was a military veteran. They were not going to reveal the reason that he got into abortion care. His father was a doctor who was killed, along with other members of his family, in a plane crash. When Dr. Tiller took over his practice, he learned that his father had been secretly doing abortions for years. The news is just going to stay away from that story because it’s too polarizing. 

So at first I was like, “Oh it’ll be cool to do a documentary about Dr. Tiller.”  But then I thought, “No, wouldn’t it be great to be in the present day lives of whoever is left doing this work?”  I wanted to look at the issue in a much more personal way, less about the abstract controversy and just more about the particulars, the intimate details; what is it like personally to do this work and why are you doing it?

Tribeca: Martha, what was your first reaction when Lana approached you with the project?

Martha Shane: (laughs) I think Lana had first mentioned to me this idea of making a documentary about Dr. Tiller. I thought that would be really fascinating, but I’ve always been more interested in doing verite documentaries. So when she had the idea of following these four doctors, I just remember being shocked that only four doctors are openly doing this work in the country. I started to wonder why are there only four? You know, what are their lives like? I was just curious about pulling back the curtain and getting a sense of their stories through their own voices. I think we’ve heard so much about abortion but so little from the patients and the doctors who are really the ones who know this issue best. I thought it was an amazing idea, and I was really excited to start work on it.

We found that in general, men are more emotional watching the movie and women are more judgmental about a lot of the patients.

Tribeca: I thought it was very interesting—especially Susan Robinson’s story—to find out how these doctors came to the practice. No one sets out to be an abortionist. They seem to have fallen into the profession in various ways out of necessity—simply because they are the only four practicing doctors in the United States. Were your surprised by their various paths?

LW: We were both surprised.  When we first found out Dr. Sella was a midwife, we were taken aback, but then we realized it makes so much sense. A lot of people who work in abortion care in general have pasts as midwives or are currently midwives. We were surprised that Dr. Carter, like Dr. Tiller, was a military veteran, which made so much sense later on because it takes a kind of stubbornness to do this work.

Dr. Carter says in the film, “The mission comes first.” Dr. Carter is even a registered Republican actually. They didn’t go into this to be political figures. They’re doctors, and they want to take care of their patients. The path to abortion care came later after they were in medical school.

MS: If you’re a heart surgeon, a certain percentage of your patients are not going to make it. Dr. Robinson has always said, “I think the amazing thing about this work is I can help every single woman who comes through these doors.” Seeing that transformation from someone who’s coming in and really struggling—grieving in certain cases about fetal anomalies or in other cases trying unsuccessfully to get an abortion for a long time—and to see them over the course of four days and help them go back into their communities prepared to move forward with their lives is an amazing experience. They really love this work.  Dr. Robinson was saying it’s like a vocation or a calling almost.

Tribeca: I was really surprised when that woman called from France and, unfortunately, they were unable to help her. Did you ever think about looking at the issue or late-term abortion in sort of a global way?

LW: We knew we wanted to focus on these four doctors and to limit our scope to them and their patients. We didn’t realize until things like this started happening that they see a lot of international patients. There are patients coming from all over the world because these are four specialists and they’re publicly known. In a lot of other countries, like France, you can’t do third-trimester abortions.

Tribeca: These 4 doctors have such rich lives—loving partners, children, etc.—outside the office. It’s hard to believe that anyone would threaten or want to inflict harm on them. How cautious were you in entering into this sort of sacred home lives of these doctors?

MS: We definitely wanted the doctors to have the option to include their families. It was sort of a given that that they would be in the film.  I think that because the doctors felt comfortable with us, their families were willing to meet us and be open to the idea.  It was definitely a privilege to have that kind of intimacy. 

Originally one of the reasons to make the film was to humanize these doctors regardless of how the audience might feel about abortion. They shouldn’t be threatened the way they are. They shouldn’t have to worry about their lives, and I think that seeing them with their families really shows that in most ways they’re just like anybody else.

Tribeca: These doctors—especially Dr. Susan Robinson and Dr. Shelley Sella—have to act almost as therapists as well. It was draining to watch them share in decision after decision with patients about whether to perform an abortion. Did the large role that empathy plays in their practice surprise you?

MS: It definitely surprised us because we’re so used to going to doctors who don’t even make eye contact or shake your hand. You’re sort of in and out in 5 seconds. I think growing up in this American health care system, it’s surprising to see how much time and how much counseling these four doctors give to their patients. That’s part of the reason why the interactions between the doctors and the patients are so intense.  

During those counseling scenes, they really just forgot about us because they were so focused on what was happening there and going through so much emotionally themselves. It’s just such an amazing thing that these doctors are able to do that, and like I said it really prepares the patients for returning to communities where people have differing views on abortions. People may ask them, “Well what happened with your pregnancy?” I think it’s really important for them to be ready to go back into that.

Tribeca: I was shocked that so many of the women agreed to let you film the stories leading up to their decisions to have late-term abortions. Their reasons ranged from fetal abnormalities, to being victims of rape, to their realization that they would be unfit mothers. Why did you choose to obscure their faces?

LW: Well, we actually offered them the option to show their face or not and the vast majority chose not to. In the end, some people showed their faces and it just didn’t work in the film once people were pretty consistent in not showing their faces.  Also, I think it gives it that extra “every woman” dimension.  You can imagine yourself more as this person somehow if you’re not seeing her face.

Obscuring the faces also helped us to demonstrate that this is such a stigmatized, secretive issue. These women are afraid of their identity being known because they’re afraid of the repercussions in their communities. So I think it gives the film extra power.

Tribeca: After hearing some of the women’s wrenching stories, it was painful to think about the protestors harassing them on their way out of the office. Did you ever want to interview a representative from the other side?

LW: No, just because we felt like that opinion is already so present in the media. We feel like those people have been interviewed constantly.  What they would have had to say that we have not heard before? Most of their message is just sloganeering and political stuff. We could have interviewed pro-choice people like that too. We could have interviewed the head of Planned Parenthood, and it would be the same thing. 

The reason we felt we could get away with not speaking to the opposing sides was that the way the doctors talk about this is not in terms of political sloganeering. The issue is much more complicated than that, and they see it in these more complex ways. They were open and candid enough to talk about their own struggles and conflicts with doing this work, especially the two women doctors who have their own process of determining the morality and ethics of their practices. They gave us a perspective we hadn’t heard before or hadn’t thought about before. 

You should only make movies that you think are on the most important subject in the world.

Tribeca: Can you discuss your collaborative process?

MS: I think different co-directors have different styles.  We basically shared all of the duties pretty equally throughout. When we were shooting, it was most important to have a really small crew so one of us would do sound and the other would do more directing and getting all these forms signed. We also had a female cinematographer with us.

During the editing process, we brought on Greg O’Toole, who also was a co-writer on the film. The three of us structured the documentary and found the narrative. It was great to have that third voice that had that fresh and shockingly male perspective.  A lot of people were surprised when we hired a man, and he was the most sensitive of the three. 

LW: We found that in general, men are more emotional watching the movie and women are more judgmental about a lot of the patients.

Tribeca: I guess could see that. There’s a sixteen-year-old girl who tells her story. You wonder why she didn’t use contraception, but she came from a heavy Catholic background. It’s easy to place yourself in her situation. You feel helpless.

LW: It’s cool that you get that though, because that’s a disconnect that other people don’t. A lot of people would look at the sixteen-year-old and be like, “She should have used contraception,” just in kind of a more judgmental way, not thinking that she was Catholic, maybe she didn’t have access to it, or maybe she wasn’t educated about it. 

You ask, “How did she get here?” Well she’s a kid. If she wasn’t taught how to avoid this situation, how can we punish her as an adult? Who’s really responsible here?  Is it this child’s or is it society’s fault? I think a lot of people just think she should have used contraception. We hope that the film provokes the kinds of questions that you have in your head.

In this country abortion is legal now as is contraception, but how are women still ending up in these desperate situations and needing abortions? You know, we need to focus on education, access to birth control – bigger picture issues that are so important.

Tribeca: So what advice would you give to other filmmakers who want to explore emotionally charged issues?  What do you wish you knew beforehand going into this?

LW: Don’t apply for grants because you won’t get them. [laughs] That’s the only thing we wasted a lot of time on. Start early. You spend all this time doing these laborious grant applications, and you’re not going to get any of them until you’re almost done filming. You just have no chance.

We learned that getting individuals behind the project was good. We did Kickstarter at first and it gave us kind of a community of people ready to go for when the movie comes out. Let’s see if they all show up this weekend or not [laughs] It was also important to involve people who are personally connected to the issue of abortion care and are really emotionally invested. They’re so much more likely to help than this anonymous government grant or something. 

Tribeca: it’s sort of difficult now in the independent film landscape to imagine life without Kickstarter or IndieGoGo.  I don’t know how filmmakers made films five years ago.

LW: Run up credit cards.

MS: [laughs] Which we did.

LW: You should only make movies that you think are on the most important subject in the world. That kind of motivates you to ask for money; it motivates you to work on the film. It’s a lot easier if you have something that you feel is really important.

I think growing up in this American health care system, it’s surprising to see how much time and how much counseling these four doctors give to their patients. 

Tribeca: In the scheme of things, do you think After Tiller will have any effect on how abortion is portrayed in the media?  What do you hope audiences will take away from this experience?

LW: You’re in these incredibly private counseling rooms and you do feel like “Should I be here?  Like should I be in the room hearing this?” I think you realize how private and personal this decision is.  We just hope – and this isn’t about polemics or about forcing people to feel a certain way –that people feel that they’ve been given a space without didactic points, that they have a space to ask questions and look carefully at their own internal values and views.

Maybe people will reevaluate a little bit and realize that this is an issue on which everyone thinks they have their position and that’s it. There’s actually a lot more grey area and wiggle room, and people can be surprised by what it brings up for them.

Tribeca: When the movie played around different festivals, was there any surprising feedback you received?

MS: I think the most interesting for us is some anti-abortion people came up to us and said, “I’m not necessarily changing my whole political stance on the issue, but this made me realize how difficult these situations are for these women. I just didn’t know what they were going through.” I think hopefully it will bring more compassion to the issue. I think a lot of the anti-abortion press against the film came from people who had not seen it yet. I hope that those people would go see the film before assuming it was going to be one way or another.

After Tiller is now playing in NYC at Film Forum and the Film Society of Lincoln Center.