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Monday, November 11, 2013

Film Follows Doctors Who Provide Third-Trimester Abortions

(Screenshot from "After Tiller")

Bullet holes in the front window of an abortion doctor’s office. (Screenshot from “After Tiller”)

In May of 2009, Dr. George Tiller, a Kansas doctor who openly provided third-trimester abortions, was shot and killed while in church.

Tiller was no stranger to risk: he had been shot before, his clinic was bombed, yet he continued to see patients and perform third-trimester abortions.

After his death, filmmakers Martha Shane and Lana Wilson started thinking — what would drive people to put themselves in such danger? So they decided to ask.

It becomes impossible to become judgmental towards these women.
– Martha Shane, filmmaker

Their documentary, “After Tiller,” goes into the lives and clinics of the last four doctors who openly perform third-trimester abortions.

“We came into the film both being pro-choice, but knowing very little about third trimester abortions,” Shane told Here & Now’s Jeremy Hobson. “It was a process of evolving. At first you can have a gut reaction to be judgmental … But when you actually listen to these patients stories, you realize that their lives are so incredibly complicated, and there are so many factors, and they are so desperate, and I think it becomes impossible to become judgmental towards these women.”

Dr. LeRoy Carhart is one of the doctors profiled in “After Tiller.”

The threats against him began almost immediately: his clinic was attacked, his barn set on fire — burning his beloved horses and animals alive – and his family was threatened.

But he continued to practice, even moving to Maryland after the procedure was criminalized in his home state of Nebraska.

“The mild personal price that we pay is nothing compared to the price the women are paying everyday to get the care that they so rightly deserve,” Carhart told Here & Now.




It has been more than four years since Dr. George Tiller was shot and killed while in church in Kansas. Tiller was one of the country's only doctors who openly provided third-trimester abortions. Now he is the subject of a documentary about what has happened since his death. It's called "After Tiller."

In the film, we hear from Tiller about the danger of his job. Before being murdered, he had been shot and his clinic was bombed.


DR. GEORGE TILLER: Postal workers, firemen, police officers, everything has a risk to it. I would prefer personally to have a challenging, stimulating, emotionally and spiritually rewarding career that is short rather than have a long one that is filled with mediocrity, feeling as if you don't make any difference to people.

HOBSON: A clip from the new documentary "After Tiller." One of the directors is Martha Shane, and she is with us now from New York. Martha, welcome.

MARTHA SHANE: Thank you, thanks for having me.

HOBSON: Well, why did you decide to make this film?

SHANE: You know, the idea, I'd been working in documentary for a little while, and my co-director had the idea while watching the news coverage of Dr. Tiller's assassination. And we talked a lot about the fact that the news, the mainstream news media, couldn't really cover this the way you would want it to. It was always a controversial abortion doctor has been killed, and then you would have a pro-choice talking point and an anti-abortion talking point, and that would be about it.

And we realized that there were so many intriguing details about this story. First of all that Dr. Tiller, who was, you know, the number one villain of the pro-life movement in this country, was actually a deeply religious Christian himself and then learning that he had actually been shot before in the arm by a protester and had showed up at work the next day to see his patients.

So we just started to think about, you know, what would motivate somebody to do this work when the risks are so great and the harassment is so regular. And we started to look at that. At first, we had the idea of making a documentary about Dr. Tiller, but then we thought it would be actually more interesting to spend time with the doctors who are still doing this work. And when we began looking into it, we discovered that there are only four in the country, and we were really shocked to discover that in a country of this size that there would be only four doctors who are openly providing these later abortions.

HOBSON: And we're going to speaking to one of them in just a couple of moments, but when you say the media wasn't covering this the way that they should be, what do you mean by that? How should they be covering it?

SHANE: You know, I think that it was just a question of feeling like it was being treated in such a politicized way and feeling like there was a need to change the tone of the conversation and to take a more intimate look at the doctors and the patients, who are the people at the heart, at the center of this storm.

HOBSON: It is very heavy, though, very even difficult to watch at times in the movie. People are going to have very different reactions to it. Did your thoughts on late-term abortions change at all in the making of this film?

SHANE: You know, that's a great question. We came into the film both being pro-choice but knowing very little about third trimester abortions, I think like most Americans. We didn't know the reasons why a woman would seek a third trimester abortion.

And so yeah, it was a process of evolving. And I think at first, you know, you can have a gut reaction, which is to be judgmental, to say, well, why did this woman wait so long, or it just seems irresponsible in some way. But when you actually listen to these patients' stories, you realize that their lives are so incredibly complicated, and there are so many factors, and they are so desperate, and I think it becomes impossible to become judgmental towards these women.

I think you realize that in order to get to these clinics, to these four doctors, that you have to be absolutely committed to this decision and have thought through this. This isn't a decision that women make cavalierly. It's a very involved and well-thought-out decision.

HOBSON: Which is not to say that everybody who sees this will agree with that decision. But you got access to some of the people wrestling with this decision firsthand. Let's take a listen to a counseling session here going on with one couple.


UNIDENTIFIED WOMAN: Ours is a corpus callosum. Obviously if the baby didn't get part of his brain, what outcome event can possibly be good? And ours has been guilt because it's guilt no matter which way you go. Guilt if you go ahead and do what we're doing or bring him in this world, and then he doesn't have any quality of life.

UNIDENTIFIED MAN: When we met with you yesterday, and when you left the room, I mean, we prayed. And I said if I'm not supposed to be here, if we're not supposed to do this, give us a sign right now and I will get up and we'll leave.

HOBSON: And of course many of the cases of third-trimester abortions are - they're done for medical reasons but not all of them. You actually spoke to some people who just simply didn't want to be mothers, right?

SHANE: Yes, you know, it was important to us that we show the full range of reasons why women were seeking third-trimester abortions. So yes, fetal anomalies, the cases where there's something wrong with the baby is part of that. But then the other reasons can be sometimes it's a young woman who didn't realize she was pregnant until very late in the pregnancy.

Sometimes it's a woman who's been trying to access an abortion for a long time but for financial or logistical or personal reasons is not able to. Sometimes it's a rape victim who is in denial. So, yes, so we felt like it was really important to include that full range and also in that way we push people, not just people who are anti-abortion but also people who are pro-choice to think more deeply about their own philosophy on this issue and their own position.

HOBSON: We're speaking with Martha Shane, who made the film "After Tiller," which goes into the lives of the last four doctors in the United States who openly perform third-trimester abortions. We will hear from one of those doctors in a moment. You're listening to HERE AND NOW.


HOBSON: This is HERE AND NOW. Let's get back to our conversation about "After Tiller," a new documentary that explores the lives of the last four doctors in the U.S. who openly perform third-trimester abortions. Before the break I was speaking with Martha Shane, who is one of the filmmakers.

Now I want to bring in Dr. LeRoy Carhart. He is one of the doctors featured in the film. And Dr. Carhart, you decided to start performing this procedure after Dr. Tiller's death, beginning in your native state of Nebraska and then relocating to Maryland when Nebraska outlawed abortions after 20 weeks. Your decision has come at a very high personal cost. Tell us what has happened.

LEROY CARHART: We've had arson once at the clinic and once at our farm, which the one at the farm was extremely devastating. But I think that the mild personal price that we pay is nothing compared to the price that the women are paying every day to get the care that they so rightly deserve. The risk and the involvement that we put into this voluntarily in reality is not much different than the postal workers put into going to work, that the Navy workers put into going to work, certainly no more greater risk than I put in every day in the military going to work knowing that somewhere in the world somebody was trying to kill us.

And part of the reason there are only four people that openly - and I think there are more doctors in the country, in fact I know there are, that do the procedures, there really is not a need for many more than four of us to do that. It's something that - it's technically very specialized, and like any other process in medicine or any other thing that you do in life, the more you do of something the better you get at it.

So four people doing quite a few are much better than hundreds of people doing one or two a year with the complications. So it's not really scary that there are only four of us. What's scary is there are - we all have grandchildren or at least are old enough to have grandchildren, so...

HOBSON: Well, are there days, though, that you, over the course of your career, have thought about what you're doing and thought maybe I won't do this, it would be a lot easier for me personally if I didn't certainly?

CARHART: Well, I think every day I realize it would be much easier if I didn't, but I think every day I realize how much I believe that it's necessary, and until I can find people willing to replace me and keep the service available. But there's no way that I can quit.

HOBSON: Well, what do you say to people, though? Because I'm sure there are people listening to this interview right now thinking, well, if these abortions are so necessary, why didn't the mother do it in the first trimester or at least the second trimester? What do you say to that?

CARHART: Many women, especially young women, find out that they are pregnant after they've spent months or weeks of either having - you know, a 14-year-old woman today, or that we've seen just recently, her periods are irregular to start with. She may not have periods every month, so maybe every two or three months.

And in addition, many women that are pregnant have periods well into the third, fourth, fifth, sixth month of pregnancy. So couple that together, and it's very easy for these young women who maybe have had sex only once or have been raped and trying to deny that it happened, and then they finally start to realize that their body is not normal, they're well into the twenty-third, fourth week before they know what's happening.

And yes, we do see these women, but it's almost always between 22 weeks and 26, 28 weeks. It's very, very rare to have a patient that's elective - and by that I mean not carrying a fatally flawed fetus or at least a severely flawed fetus, to be over 28 weeks that we do. Most of them we talk to, and they have or make other decisions that are - other options that are better for them.

But occasionally it's the right option, and you know, it's something that nobody else in the world has a right to interfere with that person and what they believe in and their physician.

HOBSON: In the film we hear from your colleague, Dr. Shelley Sella, who says this is not always easy. I want to hear a clip from her.


SHELLEY SELLA: I think about what I do all the time, and I recognize what I do, and at times I struggle, and at times I don't. But I always come back to the woman and what she's going through and often what life will this baby have. What will it mean to be alive with horrific fetal abnormalities? It's not just about being alive, it's about life and what does it mean.

HOBSON: Dr. Carhart, have you ever counseled one of your patients - or how often do you counsel them against the procedure after speaking with them?

CARHART: I personally don't believe that it's my right to counsel anyone for or against abortion. Every patient I've ever seen, before they ever come, I tell them that that's not what I'm here for. I am here to take care of a problem that that person and their physician and their religious leader that they are involved with, a decision that they came up with, I'm there to help them with it.

HOBSON: There's a scene in the movie when you walk past some of the people who are out in front of your office protesting. What do you think of those people?

CARHART: I kind of think that unfortunately many of them are there without a clue why they're there. They're there because they heard somebody tell them that abortion's a bad thing, and that's about the furthest thought they've put into the process. It would be like me saying, you know, that a radical - as a layperson, not as a physician, saying that a radical mastectomy is never indicated because we can do all these other things now.

But that's not a true statement. Unless I understand the impact of what's going on with a particular patient and her doctor and what he can do, there's no way I can make an educated decision. To me this is the most moral choice that people can make, if their heart and religion leads them to.

HOBSON: Martha Shane, I just want to finally go back to you and ask you how the film has been received. What kind of comments have you gotten from people?

SHANE: You know, we premiered the film at Sundance this year and had just an incredibly emotional screening with the doctors present. And, you know, there was a ton of security because of their presence, but then they got a standing ovation, and I think it was amazing for them to be receiving so much warmth and gratitude for the work that they're doing when there are so many people who disagree with it or who protest or harass them.

And then since then we've shown the film for audiences all over the country, and I think the most, you know, common reaction is just I didn't realize this was so complicated. And you hear that from people who are anti-abortion, and you hear that from people who are pro-choice, and that's really what we were hoping to achieve with the film. So we're glad that that's been the major reaction.

HOBSON: Dr. Carhart, has this film created more problems for you, or has it helped just to tell your side of the story?

CARHART: I don't believe it's my side of the story, but I hope - I think it's enlightened many, many people that there are two sides to the story and that they both, you know, both have a place of being considered before a patient can make her mind up.

HOBSON: The film is "After Tiller." It is currently in theaters. You can see a trailer at our website, hereandnow.org. Dr. LeRoy Carhart is an abortion provider who is featured in the film. Thanks so much for speaking with us.

CARHART: Thank you so much for asking me to be here.

HOBSON: And thanks also to Martha Shane, co-director and co-producer of the film. Thanks, Martha.

SHANE: Thank you.

HOBSON: We welcome your thoughts on this story. You can go to hereandnow.org. This is HERE AND NOW. Transcript provided by NPR, Copyright NPR.

Please follow our community rules when engaging in comment discussion on this site.
  • still free thinking

    You’re an unbiased journalist? Really? Then why did you describe the non-medical abortions as for women “who simply don’t want to be mothers” ?? As if they “simply don’t want to eat bread anymore?” ‘Simply don’t want to’ is a slam on this serious choice!!

    • Che Bianchi

      When I was a young Marxist, I thought this was just a woman’s choice. None of my business. Then I learned from my five children. To my loving wife, thank you for your choices.

    • jessi

      It is a serious choice but never the less it is a womans choice

  • jessi

    If I didnt have an abortion my baby or me or both may have not made it. Actually there is a high chance that I would have died in labor. I have a rare condition that involves large vascular malformations in my gut. People dont know the reasons why women have abortions and should not judge. Its no ones right to judge.

    • Marc Mason

      There is a right to judge. We make judgments all the time about what conduct is allowed in society, given the specific behavior and the context. The life of the mother is a widely supported exception by most people who are oppose abortion on demand. But, the reason why a woman seeks to terminate life in a pregnancy is matter about which questions should be asked and a judgement made. NO HUMAN LIFE SHOULD BE EXITED FROM THIS WORLD NO QUESTIONS ASKED, the fact that it is a woman’s choice and not man’s does not take that burden away. We all come into this way and we all have an interest in there being a question put and a judgement made when a human life is taken.

      • jessi

        Your not taking into consideration the facts i stated about my health condition and the high risk of mortality so dont give me that crap. Until your in my shoes and you know what I went through then dont judge me. Save it for someone who cares how you feel

  • interested

    can you list where and when this documentary will be shown in South Texas? Thanks

    • Rachel Rohr, Here & Now

      Hi, Here’s the link to the screening info: http://aftertillermovie.com/screenings I added it to the story above as well. It looks like there are no screenings scheduled in South Texas, but you can request one. Best, Rachel Rohr/Web Producer

  • Adriana ‘Galdo’ Adams

    I work for a Pregnancy Resource Center. We receive a lot of flack from the pro-choicers of the world who say we spend our time “talking women out of abortions” and supplying “false/biased information”. What we really do is listen to women. We hear why they feel an abortion is their only choice, provide them with a free pregnancy test and lots of resources. I would NEVER say having an abortion is a simple choice- most women do not seek an abortion flippantly. BUT, from my experience (which is considerable), most women are not fully educated on their options. We want to provide that.

    • Faith_Workman

      Is your “Pregnancy Resource Center” Christian-based?

  • Annie

    You talk about this “choice” like it’s nothing! It’s another LIVING person that you’re making this “choice” for. What about the life of the baby? Did you research what happens to these babies, how they’re torn apart, or chemically burned until they die? or their skulls crushed and their spines snipped? This is NOT unbiased reporting. I know this will probably be deleted so people can continue to live with their blinders on. Also, you talk of the women, how many women did you talk to that had abortions and really spoke honestly about their feelings with their choice? I’ve worked with many of these women in crisis pregnancy centers. I have yet to meet 1 woman who’s come and said she didn’t regret aborting her baby, that she wished she could go back and give her baby a chance, even if it meant placing her baby up for adoption. We need to give these women more information on what their choices are, too many of them were only faced with the option of abortion, and thus feel the regret, pain and guilt of their “choice” for the rest of their lives.

  • Marc Mason

    The idea that a human fetus fully formed with a heart beat and a functioning brain, already aware of its environment -even from outside womb- falls so short of being a human being that it can be killed at someone else’s discretion no matter the reason is not humane PERIOD. The right to life is a fundamental human right, it is not the peculiar belief of any one religion. The right to life cannot be segregated from the public square as only a religious POV. Some would have birth prevented, paid for by society as a human right, and aborted at public cost as a human right. But, the life that spans in between has no rights, no public guardian, only because it cannot be seen, heard or walk? WHY THE GREAT GAP IN HUMAN RIGHTS? Why do we build walls of rationalization to shut out the suffering this life being killed endures? Abortion is age old, it is not a modern thought to provide it. If society has any just intrusion into privacy, it is to protect life on the margins, life pending, pre-natal, greatly old, ill or infirmed, life not able to defend itself. This is not only religion, it should be reason.

  • fsbi2

    “I’m here to take care of a problem” – Carhart
    Lets have a round of applause as we throw another “problem” on the pile with 50 million others…

  • anotheroneofus

    I am uneasy about how this film will portray those who oppose abortion. The doctor/abortionist who was interviewed painted them as ignorant and uneducated. Arson,assassination, and violence are NOT what the pro-life movement is about. It’s unfortunate those things happen. People who committed crimes should be brought to justice and not used as an example of the mindset of people who oppose abortion. The doctor himself claimed he didn’t fear for his life anymore than he would if he were a postal worker. There are many VERY educated medical professionals and others who oppose abortion especially 3rd trimester abortions. We can keep alive 50-100% of babies born at 24 weeks or later (some sooner) in the NICU. The 3rd trimester doesn’t even begin until week 27. When does the baby have rights? It IS controversial and complex. As far as quality of life goes, how do you know? If the baby is aborted, I guess you don’t know what good could have come from his or her life either emotionally or in medical advancement. I would have liked to hear more from a respected medical professional who disagreed with 3rd trimester abortions and I am willing to bet there will not be any in the film either.

    • J__o__h__n

      How many churches have the pro-choice side bombed? How many priests and protesters did they murder? Violence is certainly what a faction of the pro-life movement is about.

      • Adriana ‘Galdo’ Adams

        A faction- a very, very small faction. That is like saying all people of musilm faith are terrorists.

        • J__o__h__n

          No, it is saying like a faction of them are, which is true. Obviously not all, which is why I wrote “fraction.”

      • F. Hannon

        Dear J_o_h_n,
        Um, aren’t you being a little audacious there, considering that the whole damn stock in trade of the “pro-choice” business is death?!!

      • Open Mind Eyes Heart

        It is true, some fight violence with violence.

    • Open Mind Eyes Heart

      Here is my review: Hear is my review of After Tiller: http://johnstuarts.wordpress.com/2013/05/31/after-tiller/

  • Been there

    Over 20 years ago I had an abortion at 21 weeks. Late 2nd trimester. Through genetic testing we learned that the baby was trisomy 21. Down’s syndrome. We learned a lot about how this manifests itself, and the presentation is wide ranging. In some cases the percentage of cells effected is small. In our case it was present in every cell examined. This increased the likelihood of extensive health issues beyond mental retardation. It was not an easy choice, with many tears, but I do not to this day regret my choice. I don’t know that I would have chosen to have another child if I had proceeded with this first pregnancy. I only know I can not judge anyone else’s choice. My choice was not trivial, or simple. But in the end, it was the right one for me. I am glad I had an excellent medical team who helped me through the process. I don’t take their choice for granted. I am glad to hear that this film has been made to open the curtain beyond the screaming rhetoric, and simplistic solutions. Unless you have faced the choice yourself, you can not possibly know the intricacies of the decision.

    • Also been there

      Me too. Anyone who has not faced this choice knows not of what they speak.

  • Mary Faith

    If abortions were free, the abortion industry would cease. This is a HUGE money making business. This is more $$ than choice.

  • Dottie

    fsbi2, my thoughts exactly. That comment right there said it all. I don’t protest at abortion clinics, so I have no personal reason for what I’m about to say, but Carhart’s comment about the majority of people who protest not having a clue of what they are protesting about couldn’t be more wrong, & it was extremely insulting to those people. They are more knowledgable about what happens during an abortion than the women getting them because those women aren’t told the truth – the truth as in the examples Annie gives. And the protestors are definitely more aware of the after-affects these women suffer than the “doctors” are because the “doctors” don’t deal with them years after they’ve performed the abortion. They don’t care! They will never admit it, possibly even to themselves, but the truth is that the abortion providers make lots & lots of money & THAT’s the real reason behind why they take the risks every day, not because they feel sorry for women & want to help them. Money is a very powerful incentive. The majority of women are not in Jessi’s situation. To try & rationalize that it’s okay to kill a living human being because of any other reason is just unfathomable to me. It makes as much sense to me as someone deciding that all women who don’t have blonde hair & blue eyes (sound familiar?) are a “problem”, as Carhart so eloquently put it, & we all need to be killed. Sounds extreme, but if we continue, as a society, to accept the reasons being given for it being okay to kill an innocent baby who has done NOTHING to deserve such a brutal death, then anything’s possible. I really hope that Here and Now gives someone the chance to let the public hear the other side of the story on the air. If not, I doubt that I will continue to listen to this station, & will definitely not help fund these types of biased broadcasts. And I can hardly wait to see how “unbiased” the documentary is.

    • Open Mind Eyes Heart

      Hear is my review of After Tiller: http://johnstuarts.wordpress.com/2013/05/31/after-tiller/ The film is well done and convincing. Everyone is on their best behaviour. Much of the reality of abortion, especially women who are pressured or feel they have no choice is left out. One such woman gave her interview for my film. The directors cut is available online now.

  • Dottie

    Been There and Also Been There – I HAVE faced this choice, and know my choice to have my child, who is now 30, was the right one. I never ever questioned what the right thing to do was, despite my circumstances, because I knew what happens in an abortion. Most of these poor women don’t know, until it’s too late.

  • Shianne

    I’m here today because my Mom chose life! She was young and faced pressure from her Mother to have an abortion. Not to say her road was always easy, it wasn’t, but I’m so thankful she chose LIFE!

  • Deacon Gaspar DeGaetano

    Human life begins at conception, basic common sense and basic science.

  • Josephus

    A little frustrated that the two sides of the debate were labled, ‘pro-choice’ vs ‘anti abortion’ by the person being interviewed with no push back. That was more than a little slanted.

    Intruiged by the potential ‘Christian’ faith of these late term abortion doctors.

    Looking foward to seeing the documentary. My wife and I already know the question does have gray areas, and hope that the viability of the pregnancy does come into the debate.

  • F. Hannon

    If you listen closely to the director, Martha Shane, as well as to the “abortion provider”, LeRoy Carhart, you hear them admit that some late term abortions are performed on babies with no health defects. While the practice is barbaric anyway, that particular circumstance particularly underscores the outrageousness of this enterprise.
    If Ms. Shane and Mr. Carhart insist on the legitimacy of a mother choosing to have her unborn baby (healthy or otherwise) maimed to death, then they cannot deny that very same legitimacy in one Mr. Scott Roeder choosing to fire a bullet into the head of another abortion provider, George Tiller.
    Radical relativism is a double-edged sword whose logical conclusion is chaos.

  • Jemma

    Thank heavens for doctors who have the courage and compassion to help women when they most need it. Women must always take control of their lives and they must always have a choice in a democracy. Film makers with integrity can help us see the truth and not what is most often sorely depicted and abused by the media. A more profound understanding of a divisive issue should be something each of us strives for. The individuals who protest too much are often those who view life rigidly or religiously, and unfortunately, without compassion for their fellow human beings.

    • F. Hannon

      “The test of the morality of a society is what it does for its children.”
      ~Dietrich Bonhoeffer
      I don’t think ole’ Dietrich had butchering the sick ones in utero in mind.

    • annie

      Except compassion for the innocent babies being murdered in their mothers womb? such a double standard!

  • Open Mind Eyes Heart

    One reality overlooked in After Tiller is that there are young girls and women who are pressured into this decision. One gal interviewed in my film muvi.es/w4441 was a teen when Dr. Tiller aborted her baby, “no questions asked”.

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