The most important communication in Never Rarely Sometimes Always happens without words. Instead, a camera lingers closely on the back of 17-year-old Autumn (Sidney Flanigan) as she changes out of her grocery store uniform in a backroom; her bra straps dig a little bit deeper than usual in her skin. Autumn’s best friend/cousin Skylar (Talia Ryder) notices, and when Autumn sprints away from her register one day, she instinctively finds her in the bathroom. We hear Autumn vomit; we don’t hear her tell Skylar she’s pregnant. Skylar just knows.

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This unspoken gravity holds together Never Rarely Sometimes Always, an achingly observant if pathologically spare movie from the writer-director Eliza Hittman which dwells in the mundane, confusing and quietly devastating moments of teenage pregnancy and abortion access in Trump-era America. Called a slut by male classmates (all the men in this film are either assholes or creeps) and neglected by parents exhausted by making ends meet, Autumn’s only resource in her small Pennsylvania town is the local crisis pregnancy center, which purports to educate women about their choices but in effect counsels against “abortion-mindedness”. The specialist at the center speaks to Autumn with patronizing concern, and as the only person besides Skylar in town who knows of her condition, takes an interest in her; she also shows her a VHS tape which violently equates abortion to murder.

Autumn googles self-induced abortion, the preface to one of many wordlessly brutal scenes, then how to get an abortion in Pennsylvania. The state requires women under 18 to receive parental permission, one of the many, many restrictions on abortion access enacted by conservative state legislatures since the 1973 supreme court decision Roe v Wade preserved a woman’s right to an abortion in the United States. So the girls board a bus to New York City with a little cash pilfered from their creepy store manager and smartphone directions to a clinic in Brooklyn. Hittman’s depiction of the city is, like the rest of her film, vigilant but passive. This is a city of hurdles and prizes, through which the girls pass nearly invisible. Their obstacles are both foreseeable – with no place to stay, they ride the trains back and forth at night – and unexpected. Farther along than she was initially told, Autumn requires a two-day procedure. A young man they met on the Greyhound bus (Théodore Pellerin, the right mix of friendly and skeevy) becomes a queasy lifeline.

It’s hard to watch this movie outside its context, as states across America cracked down on access to abortion services. In 2019, 12 states passed abortion restrictions – some at as early as six weeks, before many women, including Autumn, know they’re pregnant. Alabama attempted to ban abortion outright. Just last week, oral arguments began in a supreme court case over a Louisiana law that observers worry could undermine Roe v Wade. Never Rarely Sometimes Always smartly refuses to name these distressing developments outright, nor does it wade into didactic political messaging. But the stench of gaslit doubt and judgment suffuses the film. There’s no mention of so-called heartbeat bills, but there is a heartbeat – on the monitor at the pregnancy center, where the provider tells Autumn, without asking her plans, that it’s the best sound she’ll ever hear. Autumn’s journey out of state for an abortion is one an increasing number of American women will have to make – if they can make it at all.

Facebook Twitter Pinterest Talia Ryder in Never Rarely Sometimes Always. Photograph: Courtesy of Focus Features

Dire context aside, Hittman steers clear of melodrama, and the choice to observe two teenage girls assess their situation and navigate their options, sans capital T Tragedy or twist ending, feels refreshing. The film’s most poignant scene, which attracted buzz at Sundance and gave the film its title, captures an ordinary intake session for Autumn’s second-trimester procedure at a Manhattan clinic. The counselor quizzes Autumn on her medical history with escalating emotional severity – does she have any allergies? Has anyone made her have sex against her will? – with four response options: never, rarely, sometimes, always. Each word carries a short lifetime of unspoken pain. No need to detail it. The ordinary questionnaire is enough.

What’s not enough is the dialogue between Autumn and Skylar; Hittman’s attentive passivity works well in finding a compelling angle into an explosive political issue, but too often it extends to the characters themselves, who frequently go through whole scenes barely speaking. Flanigan and Ryder are capable actors, especially in performances as constrained as these, but too often, Hittman relies on a pained look between the girls to stand in for an unshakable bond that hasn’t been given time to imprint on the viewer. Small hints – a joke in a diner booth in New York, bonding over makeshift deodorant in a public restroom – suggest a more playful, generative bond, the kind of know-what-you-need-without-saying-it mirroring that marks the best of adolescent female friendship. But there’s too little evidence here to buy their reticence with each other.

Still, the film’s spareness has lasting power – as Skylar and Autumn boarded the bus home, I realized I had been clenching my jaw the whole movie. It’s a testament to Hittman’s portrayal of fear and frustration in navigating American reproductive healthcare as a teen. I just wish her characters had more to say about it.