‘April’ Review: A Doctor Dispenses Off-The-Books Abortions in Miraculous, Wrenching Georgian Drama

Nina (Ia Sukhitashvili), a respected OB-GYN, performs secret abortions for desperate women in deepest rural Georgia (the ex-Soviet nation, not the American state) in April, Georgian director Dea Kulumbegashvili’s wrenching second feature. As with her previous Beginning, which also starred Sukhitashvili, Kulumbegashvili marbles gritty realism in the vein of the Romanian New Wave (long takes, implicit social criticism, hyper-naturalistic performances) with a fantastical element that might be the projection of the main character’s troubled mind, a stray symbol or just a bit of experimental legerdemain.

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The surreal bolt-on doesn’t work all that well, but the limpid cinematography and more quotidian dramatic elements are impactful and striking enough to distinguish this as one of the stronger films to emerge this fall festival season. April debuts in competition in Venice and will spend part of September and beyond at fests in Toronto, San Sebastian and New York.

With laws regarding abortion and women’s reproductive health around the world changing both for the better (in Ireland and Mexico, for instance) and the worse (the United States after the Dobbs v. Jackson Women’s Health decision) over the last few years, films that explore the issue on a dramatic, granular level always feel timely if not urgent. After all, unintended or unwanted pregnancy is something nearly every woman must consider at one point in her life, for herself or someone else in her life. It’s thus no surprise that from a strictly film-industry point of view, movies on this topic do exceptionally well with juries and other award-bestowing bodies.

At the Venice Film Festival in the last 20 years alone, three of the winners of the Golden Lion have been pictures that deal explicitly with abortion or women’s right to choose: Vera Drake, Happening and last year’s Poor Things. Meanwhile, the New Romanian Cinema vibe that’s so palpable in April may bring Cristian Mungiu’s Palme d’Or-winner 4 Months, 3 Weeks and 2 Days for some viewers, with its similar emphasis on gynecological procedure and the risks involved with backstreet abortions.

In April, Nina doesn’t perform home abortions because they’re necessarily banned in Georgia. As Kulumbegashvili explains in the film’s press notes, termination is technically allowed there up for pregnancies of up to 12 weeks. It’s just that in the often very religious rural communities where the Orthodox Church still holds a lot of sway, the procedure is considered so shameful that people do not seek it out, but also cannot afford to travel the distance to a major city like Tbilisi to get one — something Americans in red states will be able to relate to. In this very patriarchal society, where marriage for girls under 18 is technically illegal but happens all the time, a young woman is even afraid to get birth control pills, as we see in a midpoint scene here, and must promise to keep the ones Nina gives her a secret.

By this point, we’ve learned that our protagonist is nothing if not a risk-taker, compelled by reasons that are not explicitly spelled out but seem to have something to do with her vocational commitment as a physician, with maybe a touch of trauma in there somewhere. In one early scene, we hear her tell a story about how, as a child, her sister got stuck in the mud by a lake. Nina was so petrified with fear that her sister would drown, she could neither leave to go get help nor get in the lake herself to pull her out.

That childhood ordeal might be why we see throughout the movie a vaguely Nina-sized naked creature-person, bald and covered in what is either sagging skin or mud, who may be a projection of her self-loathing. The swampy creature is first met in the opening shots, walking as children’s voices are heard in a blackened, glossy undifferentiated space that strongly recalls Scarlett Johansson’s lead character’s killing zone in Under the Skin. Maybe the entity is an alien, then, on earth to help harvest the unborn as a mercy for unlucky women.

As mentioned earlier, this swerve into weirdness is one of the film’s less effective mannerisms. It’s much more confident when it lets the horror remain just off screen — for example when Nina bends down to perform fellatio on a stranger she picks up off the street, or later performs an abortion on Nana (Roza Kancheishvili), a young deaf woman. The latter’s thighs and heaving abdomen dominate the shot while we hear Nina working in the background, performing a dilation and curettage on the woman’s womb. Elsewhere, we see actual footage of children being born — first in a natural birth at the very beginning of the film that produces a stillborn child, and then again in a darkened operating room where Nina and her colleague David (Kakha Kintsurashvili) perform a routine cesarean section.

In terms of bare plot, the story starts with Nina delivering that first dead baby. She is compelled to face an internal inquiry when the husband refuses to accept that the death was due to the mother’s lack of prenatal care and then refusal to have a C-section when she arrived in labor. Nina’s boss at the hospital (Merab Ninidze) is worried that her well-known abortion services will come out in the investigation — as is David, because like with sex itself, everyone knows it’s going on but no one wants to admit it. Similarly, Mzia (Ana Nikolava), Nana’s mother, who gets Nina to come perform the abortion, probably knows full well that her own husband has been raping his stepdaughter for years, but she can’t bring herself to admit it.

As if aware that all this grimness, domestic violence and abuse could be too much to bear, Kulumbegashvili and her DP Arseni Khachaturan offer the viewer intermittent bouts of beauty: panoramic shots of the mountainous landscape surrounding the village, fields of scarlet poppies or the savage skies full of a howling storm coming in fast. Even a chiffon-y pink curtain, swollen like a pregnant belly as it balloons into a room, has an everyday transcendence about it.

That extends as well to Matthew Herbert’s very subtle score (performed partly on bones, apparently), which meshes imperceptibly with Lars Ginzel’s soundscape of dog woofs, murmurs and heavy breathing. Most of the time it’s Sukhitashvili’s breathing that we hear, which sort of makes her soloist in the film’s symphonic composition. Her performance, with its clenched anxiety and brisk efficiency, is a marvel to watch, and anchors what by degrees starts to feel like a miraculous work.