There isn’t a horror director alive who wouldn’t kill to create frames as tense, ominous, and viscerally captivating as those of Georgian filmmaker Dea Kulumbegashvili, who applies her talents toward elemental character studies about rural women suffering under the yoke of patriarchy at the foot of the Caucasus Mountains.
Her debut feature, 2020’s masterful “Beginning,” tells the story of a disillusioned Jehovah’s Witness who starts to unravel after her church is firebombed by extremists in the very first shot, a static tableau held for several minutes before its Haneke-like remove is shattered with a molotov cocktail. Kulumbegashvili’s even more accomplished and terrifying follow-up “April” — which concerns a hospital obstetrician whose career is put at risk when a rare stillbirth threatens to expose her unsanctioned night job as an abortion provider — requires even less time to crush your entire being in its brace. It opens on the sight of a faceless (but visibly female) skin monster slouching through a void as Matthew Herbert’s asynchronous score breathes down your neck.
The creature appears to be an expression of the protagonist’s helplessness rather than a threat to her health, but the primal fear it personifies is real all the same. That fear — nebulous but inescapable — casts a long shadow over the rest of a harrowing film in which every scene is pulled tight by the potential for violence, and the female body is constantly framed as both the subject and the source of a horror that Nina (Ia Sukhitashvili) can only do so much to prevent.
The limits of her power are evident from the moment our heroine is tasked with delivering the child of a young woman from Kulumbegashvili’s’ hometown of Lagodekhi. The pregnancy hadn’t been registered, nor the fetus examined at any point during its development, and so Nina doesn’t learn that its lungs aren’t viable until it’s too late. Kulumbegashvili unmistakably shot a real birth for this sequence, setting the tone for a film in which the anatomical realities of birth and abortion are on full display.
“You’re a murderer,” the bereaved father says to her in the next scene, which confrontationally frames Nina against a panel of men and unfolds without a single cut of relief. He knows that Nina provides abortions to the women in his community, and the pain of losing a child has led him to conflate one part of her work with another. He demands the hospital investigate her methods, though the investigation is relegated to the distant background of a plot in which everyone already knows the score. The accusation is enough to all but guarantee the outcome.
Some context that “April” introduces ambiently or not at all, the film’s lack of exposition always to the benefit of its earthy and hyper-experiential storytelling: Abortion is legal for up to 12 weeks in Georgia, but clinics are allowed to perform them at their own discretion. Most refuse. That’s especially true in rural areas where Orthodox Christianity defines the social order, girls are often married before the age of consent, and many hospitals don’t even stock the contraception pills they’re legally obligated to provide. Outsiders are viewed askance in places like Lagodekhi, and the hostility that greets a woman like Nina when she drives into the countryside radiates through the screen like a foul stench.
The misogyny exists independent of her work. So fully devoted to her patients that she’s deprived herself of any human nourishment (“there’s no space for anyone in my life,” she confesses to her baby-faced ex-boyfriend), Nina cruises the dark highways for casual sex at night, eager to share her body with anyone who might have a use for it. She also uses the opportunity to explain what motivates her sacrifice, offering the first man she picks up a veiled story about how ashamed she would feel not to help women in need. Frustrated that he can’t get hard, he responds by slamming her head into the dashboard of her car.
“April,” which was produced by Luca Guadagnino, is unavoidably confronted by a degree of dead-end despair, but Kulumbegashvili is too earthy and open-hearted an artist to let that ugliness curdle into exploitation. Rather than settling for easy shock, she leverages Nina’s plight into a ferocious tug-of-war between sacrifice and self-obliteration — one set against the emergent warmth of a Georgian spring, which blooms under purple skies left behind by thunder clouds that sweep low over the fields like a threat from heaven. In the shallow focus close-ups that refocus the film’s terror, Sukhitashvili’s face becomes a landscape unto itself, the sunken beauty of her cheekbones hollowed out by years of holding her breath.
There’s a reluctant heroism inherent to Nina’s work (“No one wants to do abortions, but someone has to do them,” she explains, implicitly acknowledging that abortions will happen regardless of the law or whether they’re allowed to be performed safely), but Sukhitashvili’s brittle and brilliant lead performance does away with any trace of ego. She does this job because she can’t fathom a world in which she didn’t; because the fear that attends her every appointment is no match for the horror that she’s hoping to prevent, a reality that Kulumbegashvili makes unforgettably clear by the end of a thread about a non-verbal rape victim (played by a non-verbal teen from the area) whose abortion is depicted in real-time.
Bookended by the only two scenes that are integral to its plot, “April” focuses the brunt of its running time on the work that Nina continues to do while she waits for the other shoe to fall. In one sequence, she furtively prescribes the Pill to a young girl. In another, we see her administer an epidural in clinical detail — with the skill of a professional and the grace of a guardian angel.
Nina has no life outside of her work, to the point that her aforementioned ex is one of the other doctors at the hospital; they have sex on the clinic floor so that Kulumbegashvili can study the potential of their naked bodies with her camera. There is so much rugged poetry contained in this film, and yet the palpable, gnawing horror is what sees it through. We’re always on the fringes of a nightmare, whether expressed through a dark stroll through a livestock market, a visit from the Pale Lady, or a man offering to help Nina get her car out of the mud.
Life and death are as braided together in the tension of each moment as they are in the nature of Nina’s work, and “April” is suspended between them like a songbird flying headlong into a window. The empathy its heroine feels for the women around her is unbearable, but that doesn’t mean she can choose not to feel it. “Perhaps God sends us blessings so that we learn how to overcome despair,” someone says. But in this remarkable and shudderingly unresolved film, blessings and despair tend to become one and the same, two limbs of a shared body that Nina’s patients aren’t allowed to control for themselves.
Grade: A-
“April” premiered at the 2024 Venice Film Festival. It is currently seeking U.S. distribution.