Before watching “April,” the new movie from the Georgian director and screenwriter Dea Kulumbegashvili, I had seen only one other fictional film that featured a real childbirth. It was “Staying Vertical” (2016), from the French filmmaker Alain Guiraudie, and although the movie was thoroughly steeped in the absurd, the birth was filmed in a single take that left no doubt about its authenticity. I had also seen a few movies with graphic but clearly simulated scenes of abortion, including another French film, Audrey Diwan’s “Happening” (2022), and a Ukrainian drama, “The Tribe” (2015), from the director Myroslav Slaboshpytskiy. My research is admittedly spotty, but the cinema of in-your-face obstetrics has always felt like a primarily European art-film phenomenon. Rightly or wrongly, I can’t think of an American movie—not even “Never Rarely Sometimes Always,” Eliza Hittman’s rigorously observed abortion-themed drama, from 2020—that has subjected either the fulfillment or the termination of a pregnancy to such audience-discomfiting scrutiny.
Even in this squirmily confrontational company, “April” is something else. This extraordinarily bleak and devastating work, set in a damp-looking stretch of eastern Georgia, shows us a simulated abortion, two unsimulated births—one vaginal, one C-section—and, for good measure, the administration of an epidural. Each of these scenes is shot in a single, static take—composed, by the cinematographer Arseni Khachaturan, in a nearly square aspect ratio—that refuses to look away until the procedure is finished. You’re reminded that the key to realism isn’t necessarily a convincing prosthetic or a well-timed spurt of blood; it’s the weight of time itself. By granting these medical interventions their proper duration and respect, Kulumbegashvili infuses them with an element of the sacred. That’s true even of the abortion scene: a petrified young woman, who has been raped by a relative, undergoes the procedure on her family’s dining table. (Abortion is legal in the Republic of Georgia for pregnancies under twelve weeks, but it may as well not be: the Georgian Orthodox Church’s strong condemnation of abortion dominates public opinion.) The scene is a horrifying tableau, but one somehow transmuted, by the camera’s unwavering focus and the doctor’s calm, soothing ministrations, into an incongruous vision of grace.
The doctor is Nina (Ia Sukhitashvili), a highly skilled and dedicated ob-gyn specialist in her forties, who has particular expertise overseeing complicated pregnancies and difficult deliveries. The film, which unfolds over a few chilly weeks in April, 2023, is set in motion by a rare tragic outcome: Nina delivers a baby who, after a few minutes, is pronounced dead. The father (Sandro Kalandadze), grieving and enraged, accuses her of having killed the child deliberately, an accusation born of a monstrous conflation; word has spread of the abortions Nina performs in the village. A close medical colleague, David (Kakha Kintsurashvili), hearing of the abortions, warns Nina to stop, for the sake of her career: “No one will thank you, and no one will defend you.”
David, as it happens, has been asked to oversee a hospital investigation into the stillbirth, although Nina has already calmly and correctly identified the reason it happened: the pregnancy was never disclosed, and so the mother (Tosia Doloiani) received no prenatal care, leaving any potential distress signals to be discovered, too late, during labor. Unreported pregnancies, the film suggests, are not exceptional in this part of the country, where young women are pressured into marriage and procreation early on. Contraception is scarcely less frowned upon than abortion. In one remarkable scene, Nina meets with a teen-age newlywed who’s terrified to even admit that she isn’t ready for motherhood; Nina slips her a packet of birth-control pills, warning her to tell no one. Neither woman’s voice rises above a whisper, and yet we hang on their every word, and on the conspiratorial intimacy forged by the camera. Its silent watchfulness feels like a promise, as if the film itself were imposing the seal of the confessional.
Kulumbegashvili made her feature début with the aptly titled “Beginning” (2020), a drama set in a remote community of Jehovah’s Witnesses who are experiencing violent attacks by extremists in the surrounding Orthodox majority. Sukhitashvili starred in that film, too; she plays Yana, a preacher’s wife, who gradually comprehends—and begins to push back against—the religious and patriarchal prison that has been constructed around her and the other women in her midst. It would be difficult to imagine two films more fastidiously designed to function as companion pieces than “Beginning” and “April,” both of which draw on the same deliberate, contemplative stylistic well and are built on extreme contrasts of human experience. In each of these films, cruelty commingles with tenderness, and hideous acts take place against backdrops of often stunning natural beauty. Sukhitashvili magnetizes the camera with a fierce if soft-spoken intelligence—a quality of reserve that nonetheless propels her protagonists boldly forward, into personal odysseys rife with spiritual torment and sexual violence.
On at least one occasion in “April,” Nina seems to invite such violence, with a fearless knowledge of what it might entail. On nights when she isn’t at home or at the hospital, she ventures out in her car and picks up strangers for sex, for reasons that seem to extend beyond the quick gratification of a physical urge. At times, I wondered if Nina were trying, on some level, to achieve an ever more radical empathy with her least fortunate patients, to subject herself to the rough, loveless, and altogether wretched excuses for physical intimacy that brought some of these women to her exam room in the first place. The need to strengthen one’s compassion, and cast aside all fear, appears to be of crucial significance. Early on, driving around with a potential hookup, Nina recounts a haunting memory from childhood, when she was too young—and too paralyzed by fright—to intervene in a matter of life and death. It’s the one moment when Kulumbegashvili comes close to laying Nina’s psychological cards on the table.
Fittingly, “April” itself has been structured as a kind of examination—an investigation into stark realities and regressive attitudes that are neither new nor, of course, unique to any one part of the world. Kulumbegashvili’s gaze is by turns coolly diagnostic and furiously exploratory, a dichotomy that manifests itself in the compositional extremes of Khachaturan’s cinematography. Interior spaces, like an empty hospital corridor where Nina awaits bad news, tend to be statically and symmetrically framed, an aesthetic decision that, in this environment, might evoke a sterile, clinical detachment. But Nina’s manner with her patients isn’t sterile, and her concern for their well-being is the opposite of detached. Again and again, Kulumbegashvili yanks us abruptly in and out of her protagonist’s consciousness: whenever the camera heads outdoors, it suddenly sweeps us up in a wild, rough-hewn subjectivity, taking in the beauty of spring flowers, or the chill of a rainy evening, from Nina’s vantage. These point-of-view shots are accompanied by the sound of steady susurrations, which we recognize as her breathing; it’s as if Kulumbegashvili were pressing a stethoscope against Nina’s chest, one that perceives not only her inhalations and exhalations but also the very flow of her feelings and thoughts.
Indeed, the true subject of the film’s examination turns out to be Nina herself, a doctor whose steady, unfailingly professional surface barely conceals self-lacerating anguish. But that anguish, in turn, is inextricable from—and may even give rise to—a deep and unshakable moral imperative: to do the best that she can for the women under her care. These include hopeful, expectant mothers-to-be; reluctant, terrified ones; and women who have decided that, for now, they will not be mothers at all. The film’s insistent focus on the moral determination of an abortion provider, rather than the boxed-in desperation of an abortion seeker, differentiates it, in a subtle but important way, from dramas like “Happening,” “Never Rarely Sometimes Always,” and Cristian Mungiu’s “4 Months, 3 Weeks and 2 Days” (2007). Although Mungiu’s concentrated intensity feels like one of several detectable influences on Kulumbegashvili’s work, it cannot account for a few startling moments when she abandons realism entirely.
“Beginning” ends with the sight of a man’s body disintegrating into dust—an Old Testament allusion (“to dust you shall return”), as well as a haunting leap into abstraction. “April,” methodical though it may be, brazenly pursues the inexplicable throughout. The first and last shots we see are of a naked, hulking figure, recognizably a woman but never identified, with drooping breasts, wrinkled skin, and a featureless void of a face. Early on, she shuffles mournfully through what appears to be another dimension, a zone of utter darkness. She says nothing; she doesn’t seem to have a mouth, though that doesn’t keep her from breathing and wheezing as heavily as Nina does. Could this stooped, deformed phantasm in fact be Nina—or is she a scarred vestige of her, a manifestation of Nina’s fear, her lust, or her rage? By the end, Kulumbegashvili, drawing now on New Testament imagery, has offered up still another possibility: this creature, for all her fearsome unloveliness, might be a kind of redemptive miracle, a woman’s worst fears mobilized into meaningful action. No longer suspended in darkness, she presses slowly onward, into the light. ♦
