Role Of Camera In Documentary Essays On Abortion

If you’ve never had reason to visit one, the abortion clinic–as–nexus of political turmoil can have a forbidding air. They’re often beset by protesters, they’re shutting down across the country, and states have considered regulating them like sex offenders.

Christina Cauterucci

Christina Cauterucci is a Slate staff writer.

A new documentary from Dawn Porter, Trapped, exposes abortion clinics for what they are: plain old doctor’s offices that have been singled out for attack by legislators largely motivated by a religious agenda. Trapped probably won’t convince any pro-lifers to take up the cause of reproductive justice, but it might impel the casual pro-choice viewer to activism. It’s one thing to read the bonkers abortion-restriction laws—more than 350 so far in 2016—introduced in state legislatures across the country. It’s quite another to watch abortion providers try to navigate an ever-changing, labyrinthine legal puzzle while serving a population of patients that’s growing by the day as other nearby clinics close. The film is an intimate introduction to a community whose struggles few can know: the dwindling network of doctors and clinic owners who provide abortions in the South.

Since the Supreme Court agreed to review the abortion-clinic restrictions imposed by Texas’s HB2 law, there’s been increasing chatter about TRAP (targeted regulation of abortion providers) laws, from which the film takes its name. Trapped, which opens in select U.S. theaters this month, investigates the consequences of these laws on Alabama’s only three independent clinics: Reproductive Health Services in Montgomery; Alabama Women’s Center for Reproductive Alternatives in Huntsville; and the West Alabama Women’s Center in Tuscaloosa. The last of these was forced to stop seeing patients when it couldn’t comply with new regulations, but has since reopened after filing a successful suit against the state’s health department.

When there are only five doctors performing abortions in a state of 4.8 million people, the stakes are unbelievably high. “You just pray they don’t catch a cold,” Alabama Women’s Center owner Dalton Johnson says in the film. Texas faces the same predicament—Trapped shows clinics flaming out like dying stars across a map of the state, where the majority of clinics shut down after HB2 passed in 2013. Since the closure of the Whole Woman’s Health clinic in McAllen, on the Mexican border, women from the Rio Grande Valley have been driving three and a half hours to San Antonio for an abortion. Porter interviews Marva Sadler, Whole Woman’s Health’s director of clinical services, after she learns that the clinic will have to turn away a 13-year-old rape survivor who’s 20 weeks and five days pregnant because the organization’s one Texas nurse anesthetist can’t make it. To get an abortion, the girl would have to travel to New Mexico, find a way to stay there for three days, and pay thousands of dollars. “I’m basically held hostage by [the anesthetist’s] schedule,” Sadler says, through tears. “We sentenced [the girl] to motherhood. Because what are the odds of her making that trip?”

The providers’ clear commitment to reproductive justice makes it all the more nauseating to watch Willie Parker, perhaps the most famous abortion provider in the country, counsel a patient before her abortion with a deceptive spiel mandated by the state. “I am required by law to tell you that by having an abortion, it can increase your risk for breast cancer,” Parker says. And in the next breath: “There is no scientific evidence to support that.” The ambulatory surgical center requirements are just as senseless. Sadler gives a tour of the Whole Woman’s Health clinic’s new digs, modified to comply with the new Texas law that requires abortion clinics to outfit themselves like a surgical theater. There’s a suction outlet in the wall for every bed in the pre-op area and every chair in aftercare, which Sadler says they never use. Patients used to keep their shirts on and wear a disposable garment on bottom; now they have to wear entire linen gowns, which must be sent out to wash. There’s a new pharmacy stocked with drugs the clinic never uses—Sadler estimates that they spend $1,100 each month replacing expired drugs. When the camera peeks inside the clinic’s new procedure room, the view is shocking: It looks like an operating room in a hospital. And it is, just as fit for open-heart surgery as it is for a minor procedure like abortion. Sadler says many patients now ask “Are you gonna cut me?” when they enter the room.

Another of the film’s revelations is the Christian culture shared between many of the clinics’ employees and the protesters outside. Before confronting a sign-waving mob in town for a convening of pro-life activists, Montgomery clinic escorts circle up to say the Lord’s Prayer. Parker cites his faith as the motivation behind his abortion work; a young patient in the film openly grapples with feelings of shame and fear that God will punish her for making the decision to terminate her pregnancy.

But while a large proportion of the film’s abortion providers and patients are people of color, the anti-choice activists are almost all white, a racial divide exploited by some of the protesters. “What sickens me is that you’re a black man. And you’re having black women go in there and destroying black lives. All black lives matter,” one woman says to Parker outside a clinic. “Willie Parker, he goes down to Mississippi twice a month to kill his own race,” another tells the camera. “One of the most important issues to me was to highlight how these laws impact women of color, particularly black and Latina women,” Porter told Slate. “These laws wreak havoc in these communities, and it's unconscionable for a small group of vocal protestors to have the power to put the lives of these women at risk.”

Here, Trapped becomes a love letter to clinic employees who press on in an increasingly hostile environment, knowing they could lose their jobs in an instant if some state legislator decides to hang his reelection bid on a new anti-choice bill. Sadler says when she started her career in abortion care at a Planned Parenthood in Waco, Texas, she didn’t know there was “a fight going on” around abortion. “On my first day there at that job, I was rushed by protesters telling me that I shouldn’t work there, and that I was a baby-killer, and that I was going to hell,” she says. “And I think I was bit by the bug from that day forth. If these people were fighting against it, somebody had to fight for it.”

Tribeca: A Director Explains Her Difficult Journey to Make 'Abortion: Stories Women Tell'

[Editor’s Note: Tracy Droz Tragos is the Emmy and Sundance Award-winning director behind such films as “Rich Hill” and “Be Good, Smile Pretty.” Her new film “Abortion: Stories Women Tell” will air on HBO later this year, but is premiering tonight at the Tribeca Film Festival. Indiewire asked Tragos if she’d be willing to share her experiences taking on this controversial subject and what we got was this very personal essay about the process and struggle of trying to tell the story of what women with unintended pregnancies go through to have an abortion in the U.S.]

At least half of the women in America will experience an unintended pregnancy by age 45. At 2008 rates, one in ten women will have an abortion by age 20, one in four by age 30 and three in ten by age 45. And here we are in 2016, more than 40 years after Roe v. Wade made abortion legal, with presidential hopefuls talking about punishing women who seek abortion care and with more and more restrictive state laws being passed seemingly on a daily basis. 

In 2014, I set out to make a film about abortion. I had no idea how to start, except perhaps to focus in my home state of Missouri because it is one of the most restrictive in the country, with only one abortion clinic still operating and a 72-hour waiting period legally mandated. But that was the only parameter I had at the beginning. 

How do you approach making a film about a topic that has been done before and often? And on top of that, a subject that is so charged and politicized? How do you invite a broad audience and make it even remotely watchable? How do you imagine that the film might have even a small impact on one of the most divisive issues in the country?

I’m a filmmaker who likes to go deep with personal stories – so taking on the subject of abortion was a bit out of my comfort zone, to say the least. If I was going to make this film, I had to imagine a wide view – not to politicize, but rather to hear from a range of voices and points of view, and really to listen. My intention was to add a different perspective to the abortion debate: Not only to hear from the loudest, who have their talking points perfected, but also to hear from those who have been the most left out of the conversation, and often stigmatized and shamed: women with unintended pregnancies who are abortion patients.

To be totally forthcoming, I do have an opinion on the matter. I do approach this material with a perspective and I am far from a disinterested party.  I’m a woman of child-bearing age and a mother of two daughters.  My oldest turns 11 this summer, and she’s already into door-slamming.  Basically, puberty is imminent.  In our house, when the time is right, we will discuss birth control. My goal is to have it available no matter what – with some questions asked, but not too many. And if my daughters get pregnant before they want to be mothers, my hope is that they will have access to the care they need, without shame or punishment.

And while it is certainly more comfortable to be generous with people with whom I agree, my goal with this film was to be generous with subjects on all sides of the issue, no matter what. There seems to be progress with other social and human rights issues, but with reproductive issues, our country continues to be stymied. With the conversation around reproductive rights as stuck as it is, the challenge is to listen more deeply to people with whom you may not agree. To stop demonizing and name-calling – but to reflect on the “other side.” To see the complexity that defies “sides.”

This was my approach:

Unplanned pregnancy and abortion stories. Even though I met with some eloquent advocates and activists, unless they were willing to speak from a very personal place about their experience – it became clear that they shouldn’t be in this film. On my journey to find women willing to speak openly about their unplanned pregnancies and abortion, I had to wade through the spokespeople, sitting through interviews I knew I would never use.

Access.  One of the biggest, most immediate obstacles in making the film was access, especially to patients on the day of their abortions. An unplanned pregnancy is still a very private matter even though many women have already had that privacy stripped away especially in Missouri, where even after a woman jumps through the legal hoops, there remains the emotional gauntlet. To step into a clinic means walking past a line of protestors who often are snapping photos and writing down license plate numbers, with men on megaphones that just yell shaking bloody pictures on poster-board. 

Especially for low-income women who have no access to private care, seeking reproductive health services has become a public act – like breaking a strike or desegregating a school. So, for me to meet these patients, who have been bullied and harassed, and then to ask them to share their stories with an unknown audience, was a big, perhaps even outrageous, thing to do. There was a lot at stake – both for me and them. My film and the goal of advancing the conversation relied on their stories – but who wants to go public on something like this? Especially in Missouri? Being part of a documentary like this takes tremendous courage. 

Patience. Ultimately, all I could do was state my intentions, make myself available and be extremely patient. I knew there was value in the endeavor – but on days when an entire crew sat in a break room and no patients came forward, it was nerve-wracking to wait it out. Many patients were grateful that I was making the film but couldn’t consent to being on camera – they feared the repercussions they would face in their small towns or from their families, or that they would lose their jobs. I never labeled the film as “pro-choice” or “pro-life.” I made it clear that we were capturing the stories of many women, with a range of perspectives and attitudes, whose choices were specific to their lives and pregnancies. For the women who ultimately chose to be on camera, there was often a strong desire to speak of their choice, to shed some measure of the stigma they knew they faced. They felt victimized by the protestors in front of the clinic, and they wanted to reclaim their power and their voice. Every one of our subjects spoke of the desire to support other women in their same circumstances, to help ease their shame and feeling of isolation.

Strength In Numbers. Even though my tendency is to stay away from films with lots of people – I am terrified of over-populating a film – that’s what this film needed. The circumstances of why a woman might seek an abortion are so individual and so varied, we had to go wide. There is strength in numbers here, and this film was going to hear from a lot of women. Ultimately, over time, I was able to speak with over forty women – both pro-life and pro-choice. I spoke with women who looked back on their abortions years later with a range of emotions – some with gratitude and some with nostalgia. I also spoke with women who chose to carry their unplanned pregnancies to term, and had their plans for the future derailed as a result. I spoke with a couple who had placed their child for adoption – and were grief-stricken. There was no box in which to put any of these stories – patients were in their 40’s and teens, in stable and unstable relationships, all races and economic backgrounds. There were students, nurses, waitresses, accountants, paralegals, hair stylists, security guards. Simple-speaking women who believed in God; women who had children, loved being mothers and knew what was involved; women who were in abusive relationships and saw this as the only way out.  Abortion could not be reduced to a single story.

Support. Making a film that focuses on abortion is not for the faint of heart – and especially one that tries to take new point of view. I would never have had the guts without Sheila Nevins and Sara Bernstein at HBO Documentary Films. Without them, these risks would not have been taken, stories would have been over-simplified, and the film would never have seen the light of day. I am grateful to have had these documentary goddesses in my corner. When approaching such a divisive and well-covered issue, it was vital to have their collaboration and support.
Ultimately, through personal stories, I hope our film succeeds in transcending advocacy, and feels watchable no matter what the viewer’s political persuasion. My experience making this film made me realize how devastating it is to deny women access to the healthcare they need – whether it’s education, birth control or abortion care. With its intimate look at the real lives of real women, perhaps this film might move the debate, even just a bit, out of the realm of rhetoric, away from ideology and all that damning to hell, to a place of empathy and compassion for every woman who faces this important and intensely personal decision. 

“Abortion: Stories Women Tell” premiered at the 2016 Tribeca Film Festival. 

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Check out another Tribeca premiere below, with the “LoveTrue” trailer:

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