Q & A Abortion

‘After Tiller’ Filmmaker Martha Shane Discusses Screening the Film in Wichita

Kari Ann Rinker

Rewire recently spoke with Shane about the film and what it meant to show it in Wichita, where Dr. George Tiller practiced and was killed by anti-choice terrorist Scott Roeder.

Since its debut on September 20, the documentary After Tiller has captivated audiences and sparked thought-provoking discussions about later abortions and the physicians who provide them. The film has been screened at this year’s Sundance Film Festival and in 25 cities across the globe, but it has likely never been more highly anticipated than it was at its November 20 debut in Wichita, Kansas, the city that Dr. George Tiller called home.

There are many reasons why After Tiller is a must-see film. The feminist and reproductive health communities have provided much commentary about it since its release. But even more important are the perspectives of people outside these communities, for whom the film may provide an introduction to the myriad reasons why women seek abortions later in their pregnancies.

In Wichita, the film was shown to a packed house at the Orpheum Theatre. There were metal detectors at the door and security was ever-present, but the crowd appeared to be largely pro-choice and there were no disruptions of any kind. The film was followed by a panel discussion, featuring the movie’s co-producers and directors—Martha Shane and Lana Wilson—along with Julie Burkhart from the South Wind Women’s Center, which is housed in the facility where Dr. Tiller practiced, and Scott Stringfield, the medical director from Choices, the crisis pregnancy center located next door to South Wind.

The post-movie discussion was polite, with members of the audience seeming to go out of their way to respect the dissenting opinion found among them. People in attendance included Dr. Tiller’s patients, neighbors, staff, and fellow parishioners from his church, including the man who was with him when he was shot and with whom his last words were spoken. For this audience, viewing After Tiller provided something even more than philosophical and moral musings about a complex subject matter. It provided yet another step toward healing for this community so intimately aligned with the film’s namesake, their doctor, their hero, and their friend.

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Before the event, Rewire spoke by phone with one of the film’s co-directors and co-producers, Martha Shane, about the film and what it meant to host a screening in the city where Dr. Tiller practiced, and where he was killed by anti-choice terrorist Scott Roeder in 2009.

Rewire: Does showing this movie in Wichita hold a special or particular significance for you? What do you hope the effect of showing this movie in Wichita will be?

Martha Shane: I think we always have felt that it would be important to show the film in Wichita. Dr. Shelley Sella [one of the four remaining providers in the nation who openly provide third-trimester abortions since Tiller’s death] talks in the film about the climate of hatred existing in Wichita, that she felt it contributed to Dr. Tiller being murdered. As filmmakers, I don’t think we hold a particular goal for what we’re trying to achieve there, but I do imagine it will be an emotional screening. I feel that it is important that we share the film with the people who knew Dr. Tiller so well.

Rewire: People in the pro-choice movement revere their abortion providers, particularly those physicians providing later procedures. Here in Wichita, Dr. Tiller was certainly viewed as a hero to the women he helped, to the pro-choice community here, and to those who knew and loved him as a person. After spending so much time with these doctors, do you personally view them as heroes?

MS: It’s complicated. That’s not how I talk about it in the film. The question we asked the doctors when we interviewed them was, “What gives you the courage to continue doing this work?” They would say that it isn’t about courage, that it’s about stubbornness. I think that there is definitely a sense of courage in these doctors who provide this service to women.

You know, both Lana [Wilson, the film’s co-director] and I knew that we were pro-choice when we set out to make this film, but we didn’t know much about third-trimester procedures, so that has been a learning experience for us. It was interesting to us that one of our film editors said that while he was working on this project, he would try to distinguish his personal moral line with these abortions, and he said every time he thought he found the line, he then heard from a woman in the footage that would make him truly reconsider. I was personally floored by the desperation of the women we encountered while making the film.

Rewire: What of the criticism that this is not a “balanced” documentary? You said in an interview on GRITtv that you determined there’s already been enough coverage of the anti-abortion rhetoric. You said that you chose consciously to focus on the women and the “gray area” found even within the clinic. Tell me more about this gray area. What effect does highlighting this area have on the movie, and what effect could it have in the way we talk about abortion?

MS: We observed that the news media in their coverage of abortion only focuses on people who are on one side or another, but the vast majority of people are in the middle ground when it comes to this issue. The film shows the doctors themselves struggling with the complexity of their work. So the question becomes: How do we decide to provide these later abortions for these women? What moral calculus should be used? The film allows its viewers to wrestle with these issues for themselves. We hope that by embracing the complexity that we can change the way that abortion is spoken about in public.

Rewire: In Kansas, the threat to abortion comes not only from violent assassins, but also from our anti-choice, extremist legislature. Does the political element of abortion enter into the film at all?

MS: Our film follows Dr. [LeRoy] Carhart through the 20-week abortion ban in Nebraska. When we approached him about the film, he said that he had been trying for years to get legislators to come to the clinic to hear these women’s stories, but they would never come. I think it was a large reason why he chose to participate in the film. While none of these doctors chose their work for political reasons, it has become an inescapable reality for them.

Rewire: While you are here, you are scheduled to be at a fundraiser for the South Wind Women’s Center. This clinic doesn’t perform the later procedures that are featured in your film. Do the stories of the women who have non-medically necessary first- and second-trimester abortions contribute something to the discussion? What happens when there is no “gray area” and it is simply a matter of choice? Does this “gray area” allow for women who simply feel unable to proceed with a pregnancy due to a personal choice and their individual personal circumstance?

MS: I try to talk about the complexity of the issue. These women who seek first- and second-trimester abortions contribute so much to the discussion, considering one in three women have an abortion in their lifetime. The complexity is seen in every woman’s decision to have an abortion. It is a decision that each of them thinks through deeply. I think this is particularly underscored in the third-trimester procedures, but it equally true in first- and second-trimester abortions.

Dr. Sella said in a panel discussion we were on that with gay rights there have been situations with legislators, when a family member came out and it affected their personal point of view. If a legislator’s daughter had an abortion, he might not ever know. I mean, people have a right to privacy. Everyone shouldn’t have to tell their story, but if people put their story out there and talk about it, it contributes to the understanding of the issue.

Rewire: Will there be physicians willing to do this work in the future? What does the future of third-trimester abortions look like?

MS: There is a new provider who is working with Dr. Sella and Dr. Susan Robinson in Albuquerque. She’s 35 years old. They are excited about her involvement. They do hear from medical students interested in providing these procedures, but what they are most concerned about is the procedure remaining legal. The loss of legality is the biggest threat.

Our post-theatrical plans for the film are to bring it to medical schools and show it to the students. We are hopeful that it might encourage the students to demand that their schools continue to teach abortion procedures. We also hope that it would create a more supportive atmosphere for their peers who do this work in the future, by showing that they are not monsters.

Rewire: Have you had anyone share any personal change of heart with you as a result of viewing this film? What other kinds of feedback have you received from your film?

MS: At the screenings we’ve attended, we’ve had some people say that they consider themselves very “pro-life,” but that they didn’t realize how complicated the issue is. I think that it can be the beginning of thinking more deeply about the issue. That type of conversation has happened many times. I think it is definitely affecting people.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

News Abortion

Study: United States a ‘Stark Outlier’ in Countries With Legal Abortion, Thanks to Hyde Amendment

Nicole Knight Shine

The study's lead author said the United States' public-funding restriction makes it a "stark outlier among countries where abortion is legal—especially among high-income nations."

The vast majority of countries pay for abortion care, making the United States a global outlier and putting it on par with the former Soviet republic of Kyrgyzstan and a handful of Balkan States, a new study in the journal Contraception finds.

A team of researchers conducted two rounds of surveys between 2011 and 2014 in 80 countries where abortion care is legal. They found that 59 countries, or 74 percent of those surveyed, either fully or partially cover terminations using public funding. The United States was one of only ten countries that limits federal funding for abortion care to exceptional cases, such as rape, incest, or life endangerment.

Among the 40 “high-income” countries included in the survey, 31 provided full or partial funding for abortion care—something the United States does not do.

Dr. Daniel Grossman, lead author and director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California (UC) San Francisco, said in a statement announcing the findings that this country’s public-funding restriction makes it a “stark outlier among countries where abortion is legal—especially among high-income nations.”

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The researchers call on policymakers to make affordable health care a priority.

The federal Hyde Amendment (first passed in 1976 and reauthorized every year thereafter) bans the use of federal dollars for abortion care, except for cases of rape, incest, or life endangerment. Seventeen states, as the researchers note, bridge this gap by spending state money on terminations for low-income residents. Of the 14.1 million women enrolled in Medicaid, fewer than half, or 6.7 million, live in states that cover abortion services with state funds.

This funding gap delays abortion care for some people with limited means, who need time to raise money for the procedure, researchers note.

As Jamila Taylor and Yamani Hernandez wrote last year for Rewire, “We have heard first-person accounts of low-income women selling their belongings, going hungry for weeks as they save up their grocery money, or risking eviction by using their rent money to pay for an abortion, because of the Hyde Amendment.”

Public insurance coverage of abortion remains controversial in the United States despite “evidence that cost may create a barrier to access,” the authors observe.

“Women in the US, including those with low incomes, should have access to the highest quality of care, including the full range of reproductive health services,” Grossman said in the statement. “This research indicates there is a global consensus that abortion care should be covered like other health care.”

Earlier research indicated that U.S. women attempting to self-induce abortion cited high cost as a reason.

The team of ANSIRH researchers and Ibis Reproductive Health uncovered a bit of good news, finding that some countries are loosening abortion laws and paying for the procedures.

“Uruguay, as well as Mexico City,” as co-author Kate Grindlay from Ibis Reproductive Health noted in a press release, “legalized abortion in the first trimester in the past decade, and in both cases the service is available free of charge in public hospitals or covered by national insurance.”