Documenting Late Abortions: Two Providers Undaunted

An unknown number of doctors across the country perform late abortions, but unlike most, Drs. LeRoy Carhart and Warren Hern do so publicly. The film Trust Women explores their commitment to women.

Cross-posted from The Women’s Media Center.

On afternoon in late October, filmmakers Martha Shane and Lana Wilson sat at Shane’s kitchen table, creating dozens of homemade buttons that read Trust Women, the working title of their documentary. The film tells the story of two doctors who perform late  abortions, and the buttons are gifts for contributors. Only a third of the way through shooting, they say they need all the financial help they can get. “We’re also sending condom bouquets,” Shane explained, pointing to an arrangement in a vase across the table—several condoms wrapped together with pipe cleaner stems. Wilson nodded. “Maybe we can sell them as limited edition artworks.”

The idea for the documentary came to Wilson after the murder of Dr. George Tiller, who in 2009 was shot point-blank in his Kansas church. “People weren’t saying, ‘This is outrageous; this man was murdered in church!’” she said, adding that people focused on his controversial practice of performing late abortions. “Looking further into it, you learn he was a very devout Christian, he’d just gotten back from a trip to Disneyland with all his grandchildren. He’s a military veteran. And you think, ‘It’s amazing how they can vilify someone like that.’”

Wilson wondered how many doctors remained in the United States who provide late-term abortions—and are public about it. Before his murder, Dr. Tiller had already been shot by one protester, and was threatened countless times. How many other doctors were willing to endanger themselves? There remain only a few.

An unknown number of doctors across the country perform late abortions, but unlike most, Dr. LeRoy Carhart and Dr. Warren Hern do so publicly. Shane and Wilson hope to humanize the doctors—revealing more about their personal lives than Dr. Tiller ever made public—and to avoid propaganda.

“You can judge for yourself,” said Wilson, “but if you get to know them for all their complications, what you basically see is that they’re fundamentally really good people.”

Part of what makes them great subjects, Wilson said, are their differences. Dr. Carhart is a registered Republican and an Air Force veteran who owns a horse farm in rural Nebraska. He wears cowboy boots, except during the Bush administration, when he stopped for eight years. “He recently put them back on,” said Shane. Carhart is Christian and religious, but doesn’t attend church to avoid regularly exposing himself in public.

Dr. Hern was a Peace Corps volunteer in Latin America, where he witnessed the deaths of women who’d received illegal abortions. As soon as abortion was legal in Colorado, he opened a clinic. Hern refuses to use politically correct language when discussing his work. He will not say that he “provides” abortions, and instead says that he “performs” abortions.

Both are targets of threats and harassment, including clinic shootings. When Shane praised Dr. Hern for his courage, he told her, “It’s not courage, it’s stubbornness.” She says Dr. Carhart’s experience in the Air Force and Dr. Hern’s in the Peace Corps have given them each an exceptional ability to withstand pressure.

“They’re used to just saying, ‘What is the most important thing to be doing here? I have to do that first,’” said Wilson. “They both see this as the most important thing to be doing in the world.”

The most frequent circumstances that lead to late abortion—which account for less than 1 percent of all abortions in the country—include fetal anomalies, in which a pregnancy is desired, but complications develop that endanger the mother or the potential life of the fetus. Fetuses are sometimes given devastating diagnoses, such as a one-year life expectancy in excruciating pain, creating an emotional and financial strain on the parents and other children in the family.

Young women and girls who are victims of sexual abuse sometimes don’t recognize their own pregnancy—or may feel too ashamed to tell others—before the second or third trimester. For other women the process of finding a provider, securing travel, getting time off work, and accumulating the necessary funds can take several months, by which time the pregnancy is in its later stages.

Casual circumstances are much less frequent, and are grounds for refusal by the doctors. “If someone comes in and they’re seven months along, and they say, ‘Well my boyfriend just dumped me, and I really don’t want this baby anymore,’” explained Shane, the doctors won’t perform the abortion. For these women, the risk of doing a late abortion is greater than the risk of continuing the pregnancy.

Shane believes the public remains misinformed about late-term abortion for a simple reason: “Women’s voices have been hijacked by the anti-choice movement,” she said. “So many people that I consider very pro-choice, progressive people, would say, ‘Well I just can’t stomach late-term abortion.’ We need to do a better job of getting out those stories.”

Without knowledge of these cases, many lack the empathy to understand the complicated situations leading to late-term abortion; people just can’t see themselves needing one. “These are unimaginable circumstances,” Wilson said. “So it’s understandably hard for people to think outside themselves.”

Shane and Wilson, who graduated from Wesleyan University in 2005, have made two trips west to document the doctors’ lives. Spending time around abortion clinics also means spending time around protesters. “A lot of the women especially will say, ‘We’re not protesters, we’re sidewalk counselors,’” Shane said. “It doesn’t look that way to me when they’re shouting at someone walking into a clinic, but that’s how they’re defining their behavior.“

Dr. Carhart maintains that he turns away more women than the protesters do. He frequently tells patients, “‘It seems like you need to think about this decision more,’” said Shane. Both doctors are tolerant of peaceful protesters—silent prayer doesn’t bother them—although Dr. Hern points out that all of the people who have killed abortion doctors seemed harmless until they weren’t. Other protesters scream at patients, or attempt to physically assail them on arrival.

Dr. Carhart’s horse farm was burned down in 1991. A letter was sent to his family dated the day before the fire, “justifying the killing of horses, since I kill children,” Carhart said. There hasn’t been any extensive investigation into the fire, and the cause was never deemed arson—despite the fact that the fire began in eight separate locations. Shane believes this dedicated apathy is bound up in the region’s anti-choice atmosphere.

At the ages of 68 and 72, respectively, Dr. Carhart and Dr. Hern represent what could be, as Wilson calls it, “the end of an era.” Shane and Wilson hope the film will inspire future doctors to pursue reproductive health, and plan to screen it for medical students. Shane also tries proselytizing a friend in medical school. “I’m always like, ‘You should be an abortion doctor! You can have your own body guards!’”

They aspire to influence a broader audience as well, including legislators, and hope the film will help to prevent other states from following Nebraska’s post-20 weeks ban. “Imagining our greatest hopes and dreams, it would really affect the conversation about abortion in the United States…That’s our modest goal,” Shane said, smiling.

The project has already changed the perspectives of people close to the filmmakers, including Shane’s mother. “She wasn’t sure, really, how she felt about late abortion. But once she started hearing the stories, she quickly came around.” Shane paused.

“It’s amazing how quickly people change their minds once they understand just a little bit better.”

To learn more, visit the Trust Women site or the Kickstarter campaign. Buttons and condom bouquets are still available.

To help doctors improve access to comprehensive reproductive health care, visit Physicians For Reproductive Choice and Health.