What Alabama and ‘After Tiller’ Have In Common


Alabama is poised to become the latest state to restrict abortions early in pregnancy — in fact, before many women know that they’re pregnant. The state House of Representatives recently passed a measure that would ban abortions from the time that a fetal heartbeat can be detected, which can be as early as the sixth week of pregnancy. The bill, which contains other restrictions, now goes to the Republican-controlled Senate.

However, even if this bill makes off the desk of Republican Gov. Robert Bentley, there’s reason to doubt the “fetal heartbeat” measure will hold up to a legal challenge. So why pay attention to this particular anti-choice tactic, which has been defeated in other states?

One answer to that question can be found in “After Tiller,” a documentary about abortion providers—specifically, the four physicians that publicly identify as providing later-term abortions. “After Tiller” is a delicate and eye-opening film that has rightly drawn praise from those on both sides of the abortion debate; it also shows quite clearly why later-term procedures must remain legal.

Those reasons come from the women themselves, the ones that come to the clinics in their late second or third trimesters of pregnancy. In many cases, they come after tests revealed tragic, severe abnormalities: that a baby is missing half a brain, or that a baby’s bones are so fragile they will break at the slightest touch. These abnormalities, with their multi-syllabic names and horrible complications, are ones that most people will never have to deal with. So perhaps it’s not surprising that many of the 20-week abortion bans don’t include any exemption for cases of severe fetal abnormalities, or abnormalities incompatible with life.

The women that come to these clinics are painfully aware that they might be judged, even by their families, for choosing to terminate late in pregnancy. And it is clear that they and, in many cases, their partners have struggled with this choice, have struggled with what is best for a child that will be born with incredibly serious deformities. “What life will this baby have?” one expectant parent asks plaintively.

“Unless people understand what’s going on for the women, how could they support it?” one provider muses. “It sounds barbaric.” And it is in large part because of this willful lack of empathy, this refusal on the part of both politicians and the voters that keep them in office, to try to understand that later-term abortion has been restricted in all but nine states. It’s why George Bush was able to sign the Partial-Birth Abortion Ban Act in 2003, even though “partial-birth abortion” is a misnomer; it’s why the Supreme Court upheld the Act in 2007, banning a procedure that was not just considered medically safe but, in some cases, safer than other methods of termination.

But, again, why should we pay so much attention to later-term abortions, which make up only a tiny fraction of all abortions performed in the U.S.? Because the threat of violence and harassment is so real that only four doctors in the entire country will talk openly about being later-term providers. Because women that receive devastating diagnoses for their fetuses shouldn’t have to travel several states, or several time zones, from home to get competent medical care. Because the politicians and advocates that craft 20-week bans have become emboldened by their success to keep attacking legal abortion. And because once a right is taken away, it’s incredibly hard to get it back.

The rationales for banning abortion at the end of pregnancy are very different from the rationales for banning abortion at the beginning, but the goal is the same: to ban abortion. To punish women who decide not to continue their pregnancies, for any reasons.

Not all of the patients in After Tiller were terminating because of severe fetal abnormalities. One patient already had two children, and knew that it was not the right time to have another. As she talked with the doctor about her reasons for having an abortion, she reflected on how easy it was to judge someone without knowing anything about her life.

And that’s the other commonality between the barriers to receiving later-term abortion care, and the push to ban abortions at the earliest point in pregnancy. The legislators and their supporters are finding it far too easy to judge complete strangers—and far too difficult to imagine that it’s ever possible to make difficult choices with care and deliberation, and to deserve respect and compassion.

Sarah Erdreich is the author of Generation Roe: Inside the Future of the Pro-Choice Movement. She lives in Washington, D.C. with her family.