'April' review: A visceral Georgian abortion drama

Déa Kulumbegashvili's April is a bone-rattling drama about what it means to be a woman in the country of Georgia. The nation's laws permit pregnancy termination only up to 12 weeks — before some people even know they're expecting — and even then, rural stigma prevents many of them from accessing care. Kulumbegashvili places her protagonist Nina (Ia Sukhitashvili) against this volatile backdrop, as an obstetrician who risks her career by driving to far-flung villages to help pregnant women in need of abortions.

While the film's focus is the aspersions cast on Nina's character, it tells its story in oblique ways, with stunning confrontations of violence and bodily function that form a visceral fabric. The film presents life as an overlapping showreel of birth, death, pregnancy, abortion, and sex, all facets of female experience that Kulumbegashvili merges into a monstrous beast — not just narratively, but literally, through nightmarish imagery.

All the while, April unfolds with the kind of unrelenting tension that takes it from understated drama to razor-wire thriller, a metamorphosis owed not to speeding up its images, but slowing down and lingering on them for jaw-dropping lengths of time. It's a film that induces revulsion, but at the same time, is too magnetic to divert your eyes away from.

What is April about?

The opening sounds and images of April are squirm-inducing, but immediately hypnotic. A humanoid figure wanders in a dark and empty void, naked and hunched-over — either like a fetus, or an old woman — as breathy whispers consume the soundscape. These gradually transform to sounds of laughter and children playing, as though this mysterious being were separated from some phantom family by only a thin layer of reality. Even before the movie presents its subject, it calls to mind images of abortion and of aging, woven together in some nightmare of anxious regret.

Without warning, stray shots of rain and cautious observed natural landscapes yank us into a hospital room, as Kulumbegashvili captures a woman giving birth under harsh fluorescents — but this beautiful, bloody, painful miracle of life ends in death. The mother and her husband launch an inquiry against Nina as to why their baby died, placing the OBGYN under a spotlight of her own, and leaving looming doubts for the audience as to whether she was at fault.

Nina, middle-aged and single, makes for an easy target by men looking to question her character — especially as she's long been the subject of rumors about illegal abortions. Her superiors at the hospital seem willing to look the other way, but only up to a point. Given the investigation, who better to throw under the bus than the aging spinster who already has a black mark against her?

However, none of this stops Nina from continuing to to travel to rural villages on her own time to perform what she sees as her duty toward uneducated women whose lives would be ruined by unmarried pregnancy — thanks to threats from local men — even if they wanted to be mothers in the first place. She represents a choice, or at least an option, when these women have none, even if it puts her own choices at risk.

April is dreamlike, but hauntingly realistic.

Just as often as Kulumbegashvili's cuts to the aforementioned, formless creature, it presents lengthy scenes of Nina traveling to the countryside that offer space for viewers to ruminate — and to recover. The tension the movie otherwise holds can be debilitating.

Take, for instance, a lengthy abortion scene. When Nina helps a young mute girl, Nana (Roza Kancheishvili), terminate her pregnancy, Kulumbegashvili's camera — courtesy of cinematographer Arseni Khachaturan — focuses not on any one character, but the meeting of hands and bodies. The procedure itself is obscured, but the frame’s focus is Nana's torso as she lies on a plastic tablecloth. On one side of the frame, Nina works diligently to protect the young girl's future. On the other side, the girl’s mother, Mzia (Ana Nikolava), holds and comforts her. It's a traumatic sequence due to the emotions it expresses and conjures by juxtaposing a mother’s act of love with a daughter’s yelps of pain, through a procedure that could have its own serious consequences, should it be discovered.

The women in April are all caught between a rock and a hard place, and Nina's story embodies theirs in microcosm. She becomes, in the process, a kind of cypher of womanhood, and at times she even imagines herself as the formless creature (especially when she sleeps with one of her superiors), as though her self-perception and fears of aging were tied to pregnancy and sex. Her personal relationship to pregnancy, however, is never clarified — whether she's ever been pregnant, or had an abortion herself — because she seems to wall that part of herself off from other people. Perhaps it's necessary for the job.

In April, there's a violence and beauty inherent to both pregnancy and abortion, just as there is to nature. Kulumbegashvili seems to frequently draw this comparison through transitions that involve thundering rain and lush, flowery landscapes. However, violence of a different kind lurks in every corner, too, and appears suddenly, without warning. 

April makes the violence of men feel gut-churning. 

In an early scene, when the father who accused Nina confronts her, the scene is eerily quiet, until he has an outburst and spits in Nina's face. The sound this makes, and the impact it has in the process, is as visceral (if not more so) than any image of birth or abortion that Kulumbegashvili presents. Although male doctors and administrators claim to be on Nina's side, the frame places them at odds with her even in its narrow, square-ish aspect ratio, seating them at an office table alongside the aforementioned father, as though she were a criminal on trial.

The violence of men, through their actions, and through the constraints they create, is practically the glue that binds April together — even when the movie veers toward empowering carnal pleasures. Nina, perhaps to cope with the pressures ( or maybe she just feels like it) cruises through the night and picks up men to hook up with. However, there's a thin line between pleasure and pain, and not in a sexy way. Men try to take advantage of her, and become violent with a quickness, turning quiet moments oppressively loud, like gunshots echoing through the night.

There's a similarly razor-thin margin between sex and death, if only because of the consequences imposed on sex — or rather, on women for having sex — that manifests in several ways. Sex itself leads to violence. Or it leads to pregnancy, which forces some women to put their lives at risk, whether they have abortions or not. Much of this is implied or referenced rather than shown outright. But the specter of these possibilities is ever-present, reinforced through Kulumbegashvili's frames, which capture the powerful gazes of men through unbroken stares at the camera and the minimized position of women through their minuscule size in frame.

April is a ghostly film that beats with life at its most fragile, contrasted with shots of natural landscapes in ways that suggest (and force) a deeper reflection on the body and spirit. It's deeply discomforting in ways that cinema ought to be when making such a complex point about the ways women's experiences — or experiences defined by gendered violence, from the womb to the tomb — are so intrinsically bound by personal fears and desires, and by the fragility of personal autonomy in a world that so easily legislates it away through shame. It's a masterful work.

April is currently seeking distribution.

UPDATE: Sep. 25, 2024, 4:18 p.m. EDT April was reviewed out of its World Premiere at the Venice International Film Festival on Sept. 7, 2024. This post has been updated to toast its New York Film Festival premiere.