FRAMING CELEBRITY MISCARRIAGE: A TEXTUAL ANALYSIS
Thesis
Submitted to
The College of Arts and Sciences of the
UNIVERSITY OF DAYTON
In Partial Fulfillment of the Requirements for
The Degree of
Master of Arts in Communication
By
Meagan Pant
UNIVERSITY OF DAYTON
Dayton, Ohio
May 2021
FRAMING CELEBRITY MISCARRIAGE: A TEXTUAL ANALYSIS
Name: Pant, Meagan Elizabeth
APPROVED BY:
Chad Painter, Ph.D. Committee Chair Assistant Professor
James D. Robinson, Ph.D. Faculty Advisor Professor
Jennifer K. Ptacek, Ph.D. Faculty Advisor Assistant Professor
ii ABSTRACT
FRAMING CELEBRITY MISCARRIAGE: A TEXTUAL ANALYSIS
Name: Meagan Pant University of Dayton
Advisor: Chad Painter, Ph.D.
Textual analysis of four articles in which celebrities discuss their miscarriages, published in popular women’s magazines between 1987 and 2017, finds the coverage serves the media’s core function of generating empathy and creating a public conversation, both of which are important for advancing social norms surrounding taboo topics such as pregnancy loss. However, the analysis reveals that the news coverage can be inadequate in fully communicating the emotional and medical realities of miscarriage.
The framing makes salient the sadness women feel and recognizes their grief through exclusive use of familial language instead of clinical terms for the baby, but it leaves silent medical details important to understanding pregnancy loss. The coverage also exclusively uses episodic framing, focused on the individual women without broader context from sources like doctors, which encourages readers to view miscarriage as an individual issue rather than one that could be affected at the societal level through research, health care practices or public policy.
iii TABLE OF CONTENTS
ABSTRACT………………………………..…………………………………………… iii
INTRODUCTION…………………...…….……………………………………………..1
LITERATURE REVIEW………………………………………..…….………..…...….. 5
METHOD…………………………………………………………….………………… 14
FINDINGS……………………………….…………………………………………….. 20
DISCUSSION……………………………………...…………………………………... 42
REFERENCES………………………………………..………………………………... 53
iv INTRODUCTION
Miscarriage is a common, yet under-acknowledged, pregnancy outcome
(Cleveland Clinic, 2012; Bardos et al., 2015). Because it is little discussed in modern society (Bansen & Stevens, 1992), women are often unprepared for the emotional effects of such a loss (Broquet, 1999). Celebrity accounts of miscarriage shared through popular news outlets can lessen feelings of isolation among women who have suffered miscarriage (Bardos et al., 2015). It is therefore worth examining these news articles to study how celebrities talk about miscarriage. The purpose of this research is to examine news framing of celebrity miscarriage to better understand what messages women receive about pregnancy loss. Miscarriage, commonly defined as a pregnancy loss in the first 20 weeks, occurs in 10% to 20% of known pregnancies (Cleveland Clinic, 2012). Still, people believe miscarriage is a rare outcome and can be caused by things such as stress or a woman lifting a heavy object — both incorrect assumptions (Bardos et al., 2015).
Miscarriage is not commonly talked about in American society partly because of “our culture’s discomfort with death” (Bansen & Stevens, 1992, p. 89). There are not universal customs to acknowledge the loss (Friedman & Cohen, 1982) — company bereavement policies do not always address miscarriage and memorial services or funerals are not routinely held. Women often do not exhibit any physical signs they were pregnant when the miscarriage occurs (Bansen & Stevens, 1992), so they must make their own decisions about whether and when to disclose the loss (Bute, 2009). Many women report these factors contribute to feelings of guilt, isolation, depression, and stigma (Bansen &
1 Stevens, 1992; Bardos et al., 2015; Bommaraju et al., 2016; Broquet, 1999; Madden,
1994; Whiteford & Gonzalez, 1995).
Along with societal norms that encourage women to stay silent about a loss, it is also important to recognize that miscarriage is private health information.
Communication privacy management theory states private information is “owned” by an individual, meaning that person has the “right to regulate access and protection” of it
(Petronio & Steuber, 2014, p. 219). Sharing that information — with another person or with the public — risks making a person feel “vulnerable” (Petronio & Steuber, 2014, p.
3). The concept of privacy can also be explained with the idea of concentric “circles of intimacy” (Hodges, 1994). In the smallest, innermost circle, a person is alone with information, feelings, and thoughts they have not shared with anyone (Hodges, 1994).
The next outer circle is when that person shares information with one other trusted person, such as a spouse (Hodges, 1994); outside of those circles is the one with family or other close relationships (Hodges, 1994); and so on. People want to control these circles; in fact, “control over our circles of intimacy is necessary if we are to have some control over who we are” and how others see us (Hodges, 1994, p. 200). However, when it comes to privacy, celebrities “must waive all but the narrowest measure of privacy”
(Hodges, 1994, p. 207) as their appeal to fans depends on fans knowing personal information about them. For private women and celebrities alike, disclosure of miscarriage is further complicated by the fact that the loss is sometimes connected to issues of infertility. In that case, a woman may be revealing details about her partner’s private medical information as well as her own (Steuber & Solomon, 2011). It is also important to consider that while miscarriage is private information, it does coincide with
2 what people generally consider public information, including whether or not a woman has children (Bute, 2009).
Although many factors encourage women not to talk about miscarriage, a growing number are going public with their stories, including celebrities. Actress Demi Moore wrote about blaming herself for her miscarriage in her 2019 memoir, Inside Out (Itzkoff,
2019). TV personality Meghan McCain, daughter of former U.S. Sen. John McCain, wrote about her desire to grieve publicly in a 2019 New York Times op-ed (McCain,
2019). These accounts and others from famous women are worth examining because of the para-social relationship — or “seeming face-to-face relationship” (Horton & Wohl,
1956, p. 215) — people feel with celebrities. Some women who have lost a pregnancy say celebrities’ stories of miscarriage helped lessen feelings of isolation (Bardos et al.,
2015). Additionally, celebrity disclosure of health information is important because researchers have shown these accounts can drive people to seek information on the topic or even schedule doctor’s visits or tests (e.g., Ayers et al., 2016; Brown & Potosky, 1990;
Juthe et al., 2015). Brown and Potosky (1990) connected an increase in colorectal cancer screenings and calls for information to the Cancer Information Service of the National
Cancer Institute to news of former President Ronald Reagan’s colon cancer surgery in
1985. Cram et al. (2003) found a significantly higher number of people had colonoscopies in the nine-month period following television host Katie Couric’s live colonoscopy on the Today Show in 2000. Juthe et al. (2015) showed a massive increase in people seeking information on breast cancer after actress Angelina Jolie revealed she had a double mastectomy to reduce her risk of breast cancer because of her BRCA1 mutation in 2013. Ayers et al. (2016) reported a record number of online searches on HIV after
3 actor Charlie Sheen made public his HIV-positive status in 2015. Larson et al. (2005) found at least a quarter of respondents to their survey said a celebrity endorsement of cancer screening made them more likely to get tested. Furthermore, Beck et al. (2014) found that collectively, celebrities’ disclosures have not only led people to seek information or act, but they have impacted public policy and fundraising. Celebrity disclosures of miscarriage also lead more people to discuss pregnancy loss on social media, including disclosing their own miscarriages and expressing feelings of grief, anger, and isolation (Cesare et al., 2020). Not all studies focus solely on the positive effects of celebrity health disclosures. Bute et al. (2016) found that when journalist and reality TV star Giuliana Rancic spoke about her infertility and breast cancer treatment to educate others and decrease the stigma around both topics, some online commenters questioned whether she was just using her health struggles to increase her fame, and some criticized her for using expensive treatments that do not reflect an average person’s experience with either health issue.
This study, recognizing the important role celebrities and the media play in forming public perception of health issues, will add to the scant literature on miscarriage communication through a qualitative examination of how celebrity accounts of pregnancy loss are framed in popular news outlets. This research will not only add to the health care communication field, it will provide valuable insight for women and health care practitioners on how women might understand and process a miscarriage.
4 LITERATURE REVIEW
Framing theory
Framing research examines how issues are covered in the media (Weaver, 2007) to determine whether that affects the way people understand those issues (Scheufele &
Tewksbury, 2007). Journalists inevitably frame stories through the choices they have to make when reporting: What information to include and what to leave out, which terms to use, images to present, sources to quote, etc. (Entman, 1993). Framing acts like a window, limiting what someone can — and cannot — see (Tuchman, 1978). Through framing, journalists’ “subtle alterations in the statement or presentation of judgement and choice options” (Iyengar, 1991, p. 11) do not necessarily change the facts of a story, but they can suggest a certain meaning. For example, during the Vietnam War, news outlets called men who refused to serve in the military “draft evaders,” instead of using their preferred term, “draft resisters” (Tuchman, 1978). In coverage of partial-birth abortion, media use of the term “baby” instead of “fetus” drew more support for regulation (Simon
& Jerit, 2007). Language is also at the heart of debate over stem cell research, with proponents emphasizing embryonic cells and opponents focusing on embryos as human
(Williams et al., 2003). By selecting and emphasizing certain words, phrases, and images over others, media make some information “more noticeable, meaningful, or memorable to audiences” (Entman, 1993, p. 53), while other ideas become more obscure or are erased entirely (Entman, 1991). Entman (1993) explains:
To frame is to select some aspects of a perceived reality and make them more
salient in a communicating text, in such a way as to promote a particular problem
5 definition, causal interpretation, moral evaluation, and/or treatment
recommendation for the item described. (p. 52)
Entman (1991) illustrates the four functions of framing through news coverage of the
September 11 terrorist attacks. The frame described the problem, i.e. “thousands of civilian deaths from an act of war against America” (p. 6); identified the cause, i.e. the
Taliban, al-Qaeda, and the terrorist leaders; made moral judgements, condemning those groups and acts as evil; and endorsed a remedy, which was war against Afghanistan.
Over time, by repeating and reinforcing these problem definitions and solutions, and ignoring others, media encourage a certain interpretation of events (Entman, 2004), which becomes the “common sense” and “widespread” understanding (Entman, 1991, p.
6).
Framing, then, can impact how people think about an issue, what opinion they form about that issue, and whether they choose to take action (Entman, 1993; Price et al.,
1997). In a classic example, Kahneman and Tversky (1984) illustrate how people make different decisions based on a gain or loss frame. In a two-part study, they asked participants to choose how best to respond to a disease outbreak that will kill 600 people.
In the first survey, the two programs were framed in terms of the number of people who would be saved. In the second survey, the two options were framed in terms of the number of people who would die. Although Program A (“200 people will be saved”) in the first survey was equivalent to Program C (“400 people will die”) in the second, people made opposite choices. Seventy-two percent of people chose Program A, while only 22% chose Program C (Kahneman & Tversky, 1984).
6 A growing body of research illustrates the power of framing in print and television news on a range of topics. Entman (1991) compares news coverage of two instances of planes being shot down. When a Soviet pilot downed a Korean passenger plane, U.S. media called Moscow morally responsible and used terms such as “murder” and “ambush” to describe the incident. A few years later, when an American Navy ship shot down an Iranian passenger plane, those same media outlets attributed it to technical issues with military equipment and used passive language to describe the tragedy. Polls illustrated the effect of the media frames in magazine and network news, “suggesting almost everyone with opinions accepted the Soviet’s moral guilt and hardly anyone rejected it” (Entman, 1991, p. 23). However, in the case involving the American Navy ship, a majority of people believed the U.S. was not to blame (Entman, 1991). In another example, Iyengar (1990) focuses on television news, examining segments about poverty to show how framing impacts whom audiences hold responsible for the issue and whom they say should solve it. In the experiment, people who viewed news stories with a societal frame, focusing on national trends, blamed societal issues; while people viewing stories with an individual-victim frame held those people who were depicted responsible
(Iyengar, 1990). In more recent studies, Merolla et al. (2013) found that changing even a few words in articles about immigration — describing policy as amnesty vs. a path to citizenship — affected people’s support for policy change. Willis and Painter (2018) said that by framing opioid addiction and overdose as a public health issue, instead of a problem of individual crime, the Cincinnati Enquirer encouraged readers to support public policies that dedicate resources to the epidemic. Elmasry and el-Nawawy (2019) demonstrated that the media reinforced fear of Muslims and Islam by using a terrorism
7 frame in coverage of the mass shooting in Orlando carried out by an American Muslim man in the days following the violence before his motive was known, while the same framing was not used in coverage of the mass shooting in Las Vegas perpetrated by a white non-Muslim man.
Without studying and comparing news stories, however, framing can be difficult to detect (Entman, 1991). To a general audience, “many of the framing devices can appear as ‘natural,’ unremarkable choices of words or images” (Entman, 1991, p. 6).
Audiences are regularly exposed to framing as journalists cover complex topics, such as stem cell research, making such topics easier to understand with frames that “play to existing cognitive schemas” (Scheufele & Tewksbury, 2007, p. 12). Additionally, the audience might not be aware that framing occurs because journalists are trained to be objective in their reporting (Bryant et al., 2013). Several factors influence how journalists frame stories, including the time constraints and deadlines they face when reporting, their own beliefs and political leanings, current societal values, and pressure from elites
(Tewksbury & Scheufele, 2009). Because of the demands of the news market and daily deadlines, most news stories use an episodic frame, focusing on individual events
(Iyengar, 2005) such as the death and destruction of a single fire. Fewer news reports use thematic framing, which goes more in-depth with context such as national trends
(Iyengar, 2005). A thematic frame would examine how national economic trends have led more people to rent apartments instead of buying homes. Frames can be located in the text (news story) and with the communicator (i.e. journalist); however, they can also be found with the receiver (reader) and the culture (Entman, 1993). So although a frame
8 might exist in a news story, that does not mean every person will interpret it in the same way (Entman, 1993).
As framing research has grown, scholars have made the argument that framing overlaps with second-level agenda setting (McCombs, 2005). While agenda setting examines how the news, through regular story selection, influences the public agenda
(McCombs, 1997), second-level agenda setting deals with characteristics of the topic.
McCombs (2005) explains: “For each object on the agenda, there is an agenda of attributes that influences our understanding of the object” (p. 546). With this second level, the media “not only can be successful in telling us what to think about” (agenda setting), “they also can be successful in telling us how to think about it” (second-level agenda setting) (McCombs, 2005, p. 546, emphasis in original). Second-level agenda setting, however, is not as broad as framing in that it does not consider the role of journalists (Maher, 2001). Instead, framing alone does this by focusing on “how and why journalists present (or ignore) competing explanations of what factors are causing a problem, and what solutions might be” (Maher, 2001, p. 88).
Framing has steadily garnered more research in recent decades (Weaver, 2007), with many studies focused on political and policy issues. Health care issues are also important because people make health care decisions based in part on information obtained from nonmedical sources, including the media (Dutta-Bergman, 2004). Scholars have examined a variety of health care issues; however, the framing of miscarriage remains an understudied area of literature.
Health and Framing
9 Scholars recognize the importance of examining the ways in which media frame stories on medical issues. Among the many health care topics that have been examined are issues dealing particularly with women’s health. Purcell et al. (2014) found that print media in Great Britain contribute to the stigma of abortion by framing it in a negative way as controversial, immoral, and risky to women’s physical and mental health; quoting anti-abortion groups as “family campaigners” (p. 1146), marginalizing the experiences of women who have had abortions, and largely ignoring the voices of men. Patton et al.
(2017) reported that major television networks in the U.S. may influence audience views of contraceptives by framing news stories following passage of the Affordable Care Act using a political frame; casting them as controversial and featuring political and religious sources in most stories, while using medical experts only 11% of the time. Additionally,
Mills et al. (2015) wrote that media may contribute to a trend toward women having children after the age of 35 in the U.K. by framing news stories, as well as television programming, of older celebrity mothers positively “as an acceptable means of reconciling competing social expectations that women should both achieve career and social fulfilment,” with little focus on the risks that accompany advanced maternal age (p.
93). This study similarly seeks to understand how miscarriage is framed in the news, building on research that has examined the psychological effects of miscarriage to better understand the impact the media may have on public perception of pregnancy loss.
Miscarriage Research
It is important to study miscarriage because a large number of women living today have experienced a loss. Between 10% and 15% of known pregnancies end in miscarriage (March of Dimes, 2017). In the United States alone, more than 1 million
10 pregnancies are lost every year (Curtin et al., 2013). It can be profound in a woman’s life.
Brier (1999) explains:
Miscarriage is especially difficult to cope with, because the experience is
permeated with ambiguity and most often is unexpected, allowing only a short
time to prepare. Contributing to the ambiguity is the absence of a person to bury
and of memories of time together to treasure and grieve. Instead, only the dream
of a wished-for future can be mourned, usually without any clearly established
rituals or adequate support. (p. 151)
Research studies involving women who have suffered a miscarriage contain similar themes of women feeling guilt, isolation, depression, and stigma. These studies offer important understanding of the experience of miscarriage, which is often silenced in everyday conversations, whether that is because of social norms that generally exclude discussions of loss, or women’s desires to avoid feeling vulnerable by protecting their private health information (Petronio & Steuber, 2014). It must be noted that these emotions are not universally felt, and many studies dealing with miscarriage involve a small number of women (Madden, 1994). Still, researchers have found that many women feel disappointment and even “anger at themselves” after a loss (Madden, 1994, p. 85).
Depression is common, with a major depressive disorder diagnosed in as many as 50% of miscarrying women (Lok et al., 2007). Screening for psychological effects following miscarriage is not common, however, researchers have found that depression and anxiety can last a year after a loss (Lok et al., 2007). Women and their partners surveyed by
Bardos et al. (2015) reported feeling guilty (47%), ashamed (28%), and alone (41%).
Additionally, 38% of women felt they could have prevented the miscarriage (Bardos et
11 al., 2015). Many women “feel surprised and isolated at the intensity of their reaction, unaware of how common it is” (Broquet, 1999, p. 12). Bansen and Stevens (1992) report that these feelings can occur no matter what stage the pregnancy was at when the loss occurred. This is especially true in Western society, where technological advances in medicine and changing societal norms have resulted in parents increasingly thinking of their unborn child as a distinct person, affecting how they experience miscarriage
(Morgan, 1996; Andipatin et al., 2019). Still, family, friends, and health care providers tend to “not appreciate or minimize the extent of the distress felt and, specifically, the degree of sorrow present” (Brier, 1999, p. 151). Some people are uncomfortable and unwilling to discuss grief and loss at all, leading to feelings of isolation by the woman who experienced miscarriage (Bellhouse et al., 2019). What’s more, because the “hush that surrounds early pregnancy,” many women suffer miscarriage without their friends and family ever even being aware, which also contributes to feelings of isolation (Bansen
& Stevens, 1992, p. 88). Additionally, the stigma many women feel after a miscarriage
“often manifests as the accusation that women have done a poor job in caring for their pregnancy or that women have intentionally caused the pregnancy loss in some way”
(Bommaraju et al., 2016, p. 63). There has been increasing focus on the need for emotional support from health care providers to curb depressions and other psychological effects of miscarriage (Robinson, 2014). Women also seek this emotional support in part by reading about other women’s experiences online — looking for ways to cope with grief, lessen feelings of blame, and memorialize their losses (Pang et al., 2018). While a growing body of research examines the emotional effects of miscarriage and how women attempt to address them, additional insight can be gained with a comprehensive
12 qualitative examination of celebrities’ stories of pregnancy loss. By doing so, this study seeks to answer the following research questions:
RQ1: What themes are present in news articles covering celebrity miscarriage?
RQ2: What primary function does the framing of articles covering celebrity miscarriage serve?
RQ3: Has framing of celebrity miscarriage changed over time?
13 METHOD
This study explores the research questions using textual analysis, “the process of decoding messages for overt and covert meanings (apparent and symbolic)”
(Machiorlatti, 2017, p. 970). Textual analysis is a qualitative research method, meaning researchers can use it to “draw meaning” from texts (Liamputtong, 2013, p. xi), develop deeper understanding of societal issues (Tracy, 2013), and “discover rather than test variables” (Corbin & Strauss, 2008, p. 12).
A qualitative approach is necessary for this study because qualitative research goes beyond counting words or otherwise reducing the text to numbers through a quantitative method to allow the researcher to more fully address complex research questions (Wienclaw, 2019). Qualitative methods “are used to answer questions about experience, meaning, and perspective” (Hammarberg et al., 2015, p. 499). For example,
Kirkman et al. (2014) used a qualitative method — semi-structured interviews — to understand whether sperm and egg donors wish to have relationships with the offspring that result from their donations. Alternatively, quantitative research can be used when
“‘factual’ data are required to answer the research question” (Hammarberg et al., 2015, p.
498). For example, quantitative methods allow researchers to track over time what percentage of survey respondents approve of in vitro fertilization for married couples struggling to conceive, where those people live, their age distribution, their average income, etc. (Kovacs et al., 2012). Additionally, quantitative methods and qualitative methods can be used to complement each other when studying an issue.
14 While qualitative research is considered more subjective, researchers can defend their work through their trustworthiness by adequately explaining how they made decisions; credibility, including by providing evidence such as direct quotations to illustrate their findings; and consistency, meaning other researchers with the same information would reach similar conclusions (Hammarberg, 2016). Qualitative researchers can use strategies to “maximize validity” (Johnson, 1997, p. 282). Along with using direct quotations (“low inference descriptors”), other strategies include multiple data sources, research methods, researchers and/or theories (“triangulation”); peer review; reviewing findings with participants; etc. (Johnson, 1997, p. 283). In qualitative work, it also is important to use “thick descriptions” (Geertz, 1973), meaning the researcher provides enough detail to illustrate, as well as interpret and analyze, what the information means in context. Geertz (1973) explains: “A good interpretation of anything
— a poem, a person, a history, a ritual, an institution, a society — takes us into the heart of that of which it is the interpretation” (p. 18). A thick description “grows out of the delicacy of its distinctions, not the sweep of its abstractions” (Geertz, 1973, p. 25). Geertz
(1973) draws on the example a of wink, which could be just a twitch of the eye or could convey flirtation or another message depending on the situation, the actor’s intention, the culture, etc.
As a qualitative method, textual analysis is appropriate for a study of media frames of celebrity miscarriage because it allows researchers to better “understand the role that the media play in our lives” and “precisely how” media “participate in the cultural construction of our view of the world” (McKee, 2001, p. 140). Textual analysis
“aspires to the level of complexity” in research “that remains true to the actual
15 complexity and contradictoriness of media artifacts” (Gitlin, 1980, p. 303). Textual analysis can examine written texts such as books or newspapers, visual content such as television shows or movies, or recorded items such as interviews (Hawkins, 2017). Bock et al. (2019) used textual analysis for its “more nuanced examination of language use, words in context, and ideological concerns” (p. 58) to study the way newspapers used the word “nipple” when writing about breastfeeding. They examined more than 2,000 articles and found the word nipple absent in most breastfeeding stories, instead seeing it mostly stigmatized as “shameful,” “naughty,” and “problematic” in entertainment coverage, such as articles about celebrity “nip slips” (p. 65). Bor (2013) used textual analysis to examine how newspapers framed Lucille Ball’s pregnancy on the popular television show I Love
Lucy — the first time pregnancy was depicted on TV. She found that the positive coverage, which was complimentary of the show’s producers, helped “normalize the very public presentation of a taboo topic” (p. 475). Additionally, Edge (2015) used textual analysis to examine how portrayals of infertility in TV and film, including reality television shows and dramas, reinforce stereotypes about the role of mothers and of women outside the home, as well as fears about “technological intervention in human reproduction” (p. 165). Although some researchers examining a text also look at its production, for example by interviewing the journalist who wrote an article, and/or the audience reaction, for example by interviewing readers, text-only analysis is a valid form of study on its own when the text is considered in the time and culture it is produced
(Fürsich, 2009). Fürsich (2009) explains:
The measure for a well-executed textual interpretation then cannot be to explain
how closely the text represents the producers’ intentions nor does it mean how
16 close does the textual analyst come to the actually prevalent audience
interpretation of the text. Instead, the textual analyst needs to establish the
ideological potential of the text between production and consumption. The
question is not how accurately does the text reflect reality but what version of
reality is normalized and as a consequence, how emancipatory or hegemonic is
the text. (p. 249)
It is important to note that while scholars use textual analysis as a method to interpret a text, they acknowledge that not all members of an audience will interpret it in the same way or how the creator intended (McKee, 2001). For example, some audience members might find a program “boring” and ignore it (McKee, 2001, p. 142). To more fully explain, McKee (2001) writes: “There is no such thing as a single, ‘correct’ interpretation of any text. There are large numbers of possible interpretations, some of which will be more likely than others in particular circumstances” (p. 140).
This study examines four examples of celebrities discussing their miscarriage(s) published in the popular media during the last four decades. The examples were selected from a list of “50 celebrities who opened up about their miscarriages” published in the
Huffington Post (Bologna, 2017). One celebrity per decade was selected: Actress Valerie
Bertinelli, who spoke to People magazine in 1987 about her miscarriage at two months pregnant (Bernstein, 1987); model Christie Brinkley, who commented for Good
Housekeeping in 1998 about suffering three miscarriages in one year (Powell, 1998); actress Courteney Cox, who shared her recurrent miscarriages in a 2003 People cover story (Schneider & Gold, 2003); and actress Melissa Rauch, who wrote a 2017 essay for
Glamour magazine in which she announced her pregnancy and disclosed a previous
17 miscarriage (Rauch, 2017). The articles total 19 pages when printed. This study uses articles published over a period of about 40 years to allow the researcher to examine changes to news framing over time. Additionally, going back to the 1980s is appropriate because the decade marks the time when literature and popular media began to increasingly address miscarriage (Madden, 1994).
The four articles for this study were selected over others because they are original interviews or writings about each celebrity’s miscarriage(s) in widely read media outlets.
Some other celebrities on the list of 50 published in the Huffington Post disclosed their miscarriage in their autobiographies, personal websites, or in social media posts, which are not as appropriate for a news framing study. Still other examples on the list are of celebrity miscarriage only briefly mentioned as part of a larger profile of the woman’s life; for example, “Inside Halsey’s Troubled Past, Chaotic Present” published in Rolling
Stone magazine, which discusses singer Halsey’s miscarriage for two paragraphs about
11 paragraphs into the article (Morris, 2016). The articles selected for this study substantially cover the celebrity’s pregnancy loss(es). They are direct interviews or writing about the miscarriage(s), not coverage of those interviews or writings in other outlets. For example, Rauch’s Glamour essay was covered by the Associated Press, The
Hollywood Reporter, The Daily Mail, CNN.com and other popular outlets. A LexisNexis search of “Melissa Rauch” and “miscarriage” returns more than 50 unique results.
Furthermore, it is appropriate to choose four articles for this study given the limited number of articles featuring celebrities directly speaking about their losses. For example,
Bertinelli is among a small number of celebrities to discuss her miscarriage in a news article published in the 1980s. LexisNexis search results for the term “miscarriage”
18 mostly show that celebrity losses were disclosed by representatives such as a publicist or manager, for example for singer Amy Grant (Trott, 1987), and commented on only briefly by a very few others, for example, entertainer Liza Minnelli (Bird & Krebs, 1981).
Additionally, on the Huffington Post list of celebrities discussing their miscarriages in the
1990s, only two other women in addition to Brinkley shared their losses in a print media outlet, and one, singer Nell Carter, is only briefly quoted on the loss in a much larger profile on struggles she has faced in her life (Gold, 1994).
This study analyzes the articles using the constant comparative method, a design based in grounded theory (Glaser & Strauss, 1967) that “allows important concepts to emerge out of the data” (Kolb, 2012, p. 86). The researcher “simultaneously codes and analyzes data in order to develop concepts” (Taylor & Bogdan, 1998, p. 164). Taylor and
Bogdan (1998) further explain: “By continually comparing specific incidents in the data, the researcher refines these concepts, identifies their properties, explores their relationships to one another, and integrates them into a coherent theory” (p. 164). This inductive method is appropriate because it allows for a close reading and evaluation of the articles through which themes emerge to address the research questions. The unit of the analysis is the article.
19 FINDINGS
In the textual analysis of the news articles, four themes were identified: (1) clear emotional effects, (2) episodic framing that portrays miscarriage as a personal issue, (3) use of familial language over clinical terms, and (4) missing medical details. The themes are discussed and explained below using specific examples.
Clear emotional effects: The news articles send a clear message to readers that miscarriage is an emotional event for a woman. Reporters prominently reference the experience as “heartbreaking” and extensively quote the celebrities about the sadness each woman felt at her loss(es). Still, much of the media coverage does not capture the full range of emotions women report in miscarriage literature; only in Rauch’s 2,000- word essay do the themes of isolation, guilt, and feeling stigma appear. These findings suggest that news can be inadequate as a source of information to help readers understand the full emotional effects women might experience after a miscarriage, although more recent coverage may be evolving to include more of such content.
Sadness — although not depression, which one might expect because it is common and can be diagnosed in as many as 50% of miscarrying women (Lok et al.,
2007) — is the most prominent feeling expressed in the articles penned by journalists, making this emotion salient to readers. It is conveyed in multiple ways: through descriptions written by reporters, word choice in headlines, and direct quotations selected for the articles.
When writing about Brinkley, reporter Joanna Powell opens her article: “She had three heartbreaking miscarriages in one year” (para. 1.) Powell later writes: “At 44,
20 Brinkley has had a year of fertility nightmares: Two miscarriages four months into each pregnancy, followed by a third, after in vitro fertilization” (para 6). The use of the term
“heartbreaking” to open the article, followed quickly by the characterization of pregnancy loss as a “nightmare,” strongly communicate to readers that miscarriage causes sorrow.
When writing about Bertinelli, reporter Fred Bernstein conveys the same message in his prominent description of her saddened mood in his article’s lede:
Something is nagging at Valerie Bertinelli. It shows. Bertinelli usually beams,
bubbles, effervesces. But not today. Her glum look is especially surprising given
her latest career coup. This week CBS is airing the eight-hour miniseries I’ll take
Manhattan based on Judith Krantz’s kinky 1986 bestseller and starring Bertinelli
as a magazine publishing heiress with a drop-dead wardrobe, three ex-husbands
and a teenage daughter... Curled up on the couch of her Malibu beach house,
Bertinelli runs a hand through her shaggy tresses and apologies for sounding
morose. (paras. 1-2)
Bernstein’s description — using words that put a visual image in a reader’s mind of
Bertinelli’s usual demeanor as someone who “beams, bubbles, effervesces” — further demonstrate that miscarriage has a profound ability to change someone’s mood. The reporter continues by explaining the reason for Bertinelli’s mournful mood:
What changed her was a string of crises. Last March, Valerie, two months
pregnant, suffered a miscarriage. ‘I’m still not over that one,’ she says. Then in
December Eddie’s father died. “Pa wanted grandchildren so badly,” says Valerie,
whose bedside table is still piled high with books on child rearing. “Goddamit, I
21 wish we hadn’t lost the baby so Pa could have at least seen the next generation.”
(para. 5)
As was the case for Powell, Bernstein’s word choice — “morose,” “crisis,” and
“suffered” — suggest the serious emotional effects of miscarriage. Bernstein also uses another tactic found across these articles to communicate emotional fallout: contrasting the image of Bertinelli as a happy starlet who has just won a major career achievement with her “glum” disposition caused, at least in part, by her pregnancy loss. People
Magazine similarly contrasts readers’ image of Cox’s popular television show, Friends, with the reality of miscarriage. In a headline about Cox’s “hope for a baby,” the magazine states that while her show “Friends is fun; the real world has rough spots.” In the article on Brinkley, Powell also uses the same device, differentiating Brinkley’s image as an “icon” of beauty and health with “the bitter twist of fate” that is her losses:
For Brinkley, the seemingly ageless icon of healthy American gorgeousness,
fertility problems were a bitter twist of fate. Cook — the man she feels destined to
spend the rest of her life with — is five years her junior and had never been
married before. And even though he claimed to be content without a biological
child, Brinkley wanted nothing more than to cement their union with a baby of
their own. (para. 8)
Powell also spends considerable space in the article contrasting the emotional effects of
Brinkley’s “fertility nightmares” (para. 6) with the happiness she feels at being pregnant at the time of the interview. Powell writes that Brinkley is “joyously expecting in July”
(para. 1) and notes she is “positively giddy” (para. 4) when she shares news that an amniocentesis test has confirmed the baby is healthy.
22 The use of direct quotations from the celebrities also strongly elaborates on the sadness one might expect following pregnancy loss. Bernstein quotes Bertinelli as saying:
“It hurt so badly when I miscarried,” she says. “I think about it often and get
down.” Valerie says she liked the feeling of being pregnant. “It was scary, but it
was neat, too,” she says, suddenly ashamed for using a kid word like neat. “I just
wanted to learn everything I could. I read all the time.” Valerie, who says she’d
like two or three children, reports that she and Eddie, 30, have begun trying again.
“If it happens, it happens,” she says, “but we’re not going to make ourselves crazy
about it.” (para. 7)
Powell, who further conveys Brinkley’s emotions by noting that she speaks “slowly” when she discusses her losses (para. 7), quotes Brinkley as explaining:
“After the first miscarriage, I tried to take the attitude that it was my body’s way
of telling me that this pregnancy wasn't meant to be, and that it was better for
everybody,” she said, slowly. “But after the second one, it was really devastating.
Four months is a lot of living with that little life in you — thinking about it, eating
right for it, nurturing it — and all of a sudden, it dies.” (para. 7)
The women’s descriptions that miscarriage “hurt,” was “devastating,” and their depiction of it as a “failure” give first-hand accounts of the emotional effects. Reporters also convey the impact through the use of quotes from family members. For example, when writing about Cox, reporter Karen Schneider quotes Cox’s husband, actor David
Arquette:
Two years later, they are still trying. Their first round of in vitro fertilization was
“nerve-racking,” Arquette says. His usual playful spirit could not block the
23 frustration and tears after each miscarriage. Says Arquette: “I feel terrible that she
has to go through so much.” The couple are cautiously optimistic about trying
IVF again. (para. 14)
Rauch also expresses “profound sadness” in her essay, but she goes further by reflecting on themes found in research, including feelings of depression, guilt, and isolation. She writes:
The miscarriage I experienced was one of the most profound sorrows I have ever
felt in my life. It kick-started a primal depression that lingered in me… I kept
waiting for the sadness to lift…but it didn’t. Sure, I had happy moments, and life
went on, but the heartbreak was always lurking. Inescapable reminders, like the
unfulfilled due date, came around like a heavy cloud. A day I had once marked on
my calendar with such excitement was now a memorial of a crushed dream. I was
constantly wishing that the feeling of being desperately lonely in my own body
would dissipate. It didn’t help that I was also fighting against these feelings with
thoughts like, You should be over this by now, and People go through a heck of a
lot worse, you miserable sad sack! (Can you tell that I am awesome at self-
compassion?) What I realized, though, is that because this kind of loss is not
openly talked about nearly as much as it should be, there really is no template for
how to process these emotions. You’re not necessarily going to a funeral or taking
time off from work to mourn, but that doesn’t change the fact that something
precious has been unexpectedly taken from your life. (para. 5)
In the above paragraph, Rauch not only directly states she experienced depression, she also touches on the isolation she felt. She later discusses the “guilt” (para. 6) she
24 experienced, even sharing her opinion that the word miscarriage itself is “one of the worst, most blame-inducing medical terms ever” (para. 7), implying the woman
“somehow ‘mishandled the carrying of this baby.’” Rauch also writes that seeing other women’s pregnancy announcements was “like a tiny stab to the heart” (para. 3) and that jealousy made her feel “guilt and shame” (para. 3):
During the time when I was grieving over my pregnancy loss or struggling with
fertility issues, every joyful, expectant baby announcement felt like a tiny stab in
the heart. It’s not that I wasn’t happy for these people, but I would think, Why are
these shiny, carefree, fertile women so easily able to do what I cannot? And then
I’d immediately feel guilt and shame for harboring that jealousy—one might call
this “the circle of strife.” (para. 2)
Rauch explains that she was “continually surprised by the constant assault of emotions”
(para. 9), and, as noted above, that because pregnancy loss is not commonly discussed,
“there is really no template for how to process these emotions” (para. 5). Her expressions of emotion are consistent with miscarriage research, where women have reported feeling guilty, ashamed, and alone (Bardos et al., 2015), as well as isolated (Bansen & Stevens,
1992) and even surprised by the intensity of the emotions they experience (Broquet,
1999). One possible reason that Rauch talks about her own experience with more of the themes women report in miscarriage research is that she chose to share her story as a first-person narrative. The fact that hers is an essay strongly suggests she had more editorial control over the message than a celebrity typically has when she is interviewed for an article that is written by — and therefore filtered through the eyes of — a reporter.
The distinction, and the greater freedom and control it granted Ranch, implies that
25 women have more complex and deeper emotional reactions to miscarriage than one would typically find in articles written by reporters.
The fact that Rauch reflects on more themes in telling her own story in 2017, compared to the reported articles printed in the 1980s to 2000s examined here, also suggest that changes may be occurring to miscarriage framing. To understand potential changes in framing of celebrity miscarriage over time, one has to look at societal norms surrounding pregnancy loss. As noted earlier in this paper, the 1980s marked the beginning of some transformation — with popular media and literature increasingly addressing miscarriage (Madden, 1994). Even politicians sought to heighten awareness of the topic in the 1980s, with President Ronald Reagan signing a proclamation to declare
October “Pregnancy and Infant Loss Awareness Month” in 1988 — calling it an opportunity for Americans to “increase our understanding of the great tragedy involved in the deaths of unborn and newborn babies” (Ronald Reagan Presidential Library and
Museum, 1988, para. 1). Still, three decades later, references to the societal silence surrounding miscarriage remain prominent. Scholars continue to address it (Kai Tiaki
Nursing, 2010; Bellhouse et al., 2018). Even former actress and British royalty Meghan
Markle, Duchess of Sussex, wrote about the taboo in a 2020 New York Times essay on her miscarriage:
Losing a child means carrying an almost unbearable grief, experienced by many
but talked about by few. In the pain of our loss, my husband and I discovered that
in a room of 100 women, 10 to 20 of them will have suffered from miscarriage.
Yet despite the staggering commonality of this pain, the conversation remains
taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary
26 mourning. Some have bravely shared their stories; they have opened the door,
knowing that when one person speaks truth, it gives license for all of us to do the
same... (Markle, 2020, paras. 17-18)
Rauch’s 2017 first-person essay suggests that women are beginning to take a more direct and active role in sharing stories of their pregnancy loss than in past decades.
The timing coincides with other trends, including more women opening up about pregnancy loss on social media through campaigns such as the #IHadAMiscarriage, launched in 2014 (Zucker, 2020). Rauch uses her editorial control over her message to inform readers about the stigma surrounding fertility issues, to advocate that women seek out doctors for help, to educate on the prevalence of miscarriage, and to encourage women who have experienced such a loss — none of which is found in the articles reported by journalists reviewed for this paper. Rauch also directly addresses the stigma surrounding pregnancy loss:
Just to be clear, I’m not saying everyone who publicly announces cheerful news
should also report the crummy journey they embarked on before getting to the
other side of it. I personally just wanted to express what I’ve experienced in the
hopes that it could — in some small way — help someone going through a similar
pain. Ideally, the more we talk about this issue, the more we can chip away at the
unnecessary stigma around it, with the end result being that those of us struggling
with loss and infertility will feel less alone. Perhaps with increased overall
awareness, women dealing with these extremely challenging circumstances won’t
feel like they’re getting sucker-punched in the uterus by well-intentioned people.
(para. 4)
27 Finally, Rauch closes her essay with a message not seen in the other articles to women who are experiencing fertility issues: “You are not alone” (para. 14). Her reflection on the larger societal trends and her acknowledgement of other women who have had a miscarriage suggest that coverage of pregnancy loss is becoming more varied as additional options become available to women to share their stories.
These changing trends, however, are not obvious in miscarriage coverage written by reporters for celebrity magazines. Although only a limited number of articles featuring celebrities discussing their miscarriage can be found from the 1980s, neither Bertinelli nor the reporter make reference to the societal silence or give a reason for Bertinelli’s decision to speak about it. Similarly, the articles reported by journalists on Brinkley in
1998 and Cox in 2003 do not reference the silence nor the women breaking the taboo by talking about it. It should be noted that Cox later, in 2019, did address the taboo nature of miscarriage, saying she believes people should talk about it when promoting her web series “9 months with Courteney Cox” (Haller, 2019). Still, in these earlier articles, the celebrities discuss miscarriage as they do the other aspects of their lives covered in the articles — be it their relationships or careers. This suggests that, at least for celebrities, there is little expectation of privacy when it comes to talking about the emotional experiences in their lives.
Episodic framing that portrays miscarriage as a personal issue: The articles examined for this study focus solely on the individual experiences of the celebrities. This represents episodic framing, which tells the story of one person, as opposed to thematic framing, which puts an issue in larger context (Iyengar, 1991). Another example to illustrate the difference between episodic and thematic framing is news coverage about a
28 specific terrorist act, which would be episodic, as opposed to coverage that includes the
“underlying historic, economics, or social antecedents” of terrorism, which would be thematic (Iyengar, 1991, p. 15). The news features on miscarriage examined here include the celebrities discussing their feelings and hopes for their own futures. At times, the reporters also quote family members. However, the pieces do not include broader context from sources such as doctors, researchers, national nonprofit organizations that focus on pregnancy loss, government organizations that offer resources, etc. This episodic framing reflects and reinforces the dominate societal perspective that miscarriage is private, individual issue rather than a collective public health issue. Sharing the personal experiences of individual actresses and their emotions is important given that women report feeling less isolated when they hear celebrity accounts of miscarriage (Bardos et al., 2015). However, a thematic frame could include personal stories, but put into a larger context with expert sources and more information. This would serve to advance the public understanding of and conversation about the topic in ways that episodic coverage, without the same depth, cannot.
The episodic framing used for miscarriage is in contrast to some examples of news coverage of other celebrity health issues. For example, thematic framing can be found in articles on President Ronald Reagan’s colon cancer. Brown and Potosky (1990) noted that media coverage of Reagan’s cancer surgery included “background pieces on the nature of colon cancer and on methods of early detection, diagnosis, and treatment”
(p. 318). That coverage drove people to schedule screenings and call the Cancer
Information Service of the National Cancer Institute for information (Brown & Potosky,
1990). Additionally, Juthe et al. (2015) pointed out that actress Angelina Jolie’s New
29 York Times op-ed, “My Medical Choice,” on her decision to undergo a preventative double mastectomy due to having the BRCA1 gene — which sharply increases a woman’s chance of developing breast cancer — included a direct link to the National
Cancer Society’s Preventive Mastectomy fact sheet. A separate article by People
Magazine on songwriter and former “American Idol” judge Kara DioGuardi and her decision to have a baby via surrogate due to her BRCA2 mutation also included a direct link to the fact sheet (Juthe et al., 2015). The articles examined for this study do not include direct links to any educational resources. Additionally, when sidebars are included, they do not educate on miscarriage. For example, the article on Cox in People
Magazine includes a sidebar on “his-and-hers decorating tips” tied to Cox’s new television design show, “Mix It Up.” Similarly, the article on Brinkley, which mentions her new endorsement deal with an at-home exercise equipment company, includes a sidebar on her diet and exercise tips for a healthy pregnancy. Identifying that education resources are lacking in miscarriage coverage is important because there are widespread misconceptions about miscarriage, including about what can — and cannot — cause a miscarriage. For example, Bardos et al. (2015) in a national survey found a majority of people incorrectly believed stress or lifting a heavy object can cause pregnancy loss, and some incorrectly believed that former birth control use can be a cause as well.
The articles further communicate that miscarriage is a personal issue through episodic framing that focuses mostly on the effects for women and their families, without looking at any miscarriage trends or effects beyond that inner circle. This suggests to readers that it is typical for women in their everyday lives to not communicate their loss(es) beyond their circle of intimacy that includes their partner and family. This is
30 consistent with research findings that miscarriage is traditionally seldom discussed in society. In the articles reviewed, Powell notes that for Brinkley, few people outside her family knew about her miscarriages and fertility treatments. Powell uses direct quotes to allow Brinkley to explain to effect of the losses on her husband, architect Peter Cook:
“I would occasionally think, If anybody on this planet should be reproduced, it's
Peter,” she says. “But he has none of that ego that says, I need to have my seed
continue on... He was one hundred percent convincing when he told me that he
would be the happiest man in the world if he could have a baby with me, but that
he would also be the happiest man in the world just to share my life and kids.”
(para. 9)
Powell also notes that Cook “understood when the events wreaked havoc on her
[Brinkley’s] emotions, and she needed a shoulder to cry on in the middle of the night”
(para. 33). Bertinelli also discusses the impact on her husband, rock musician Eddie Van
Halen, and their relationship, stating that the crises in their lives, including the miscarriage, brought them “closer than ever” (para. 8). She also is quoted discussing her disappointment that her father-in-law would never meet his grandchildren (see para. 5 quote under “clear emotional effects”). Cox, when discussing her losses, also includes her husband:
“I get pregnant pretty easily,” says Cox, “but I have a hard time keeping them.”
Despite having miscarried “quite a few times,” she says, she and David “bounce
back pretty quickly. I don't say it's a walk in the park. But what are you going to
do? We just try again.” (para. 7)
31 Although each woman shares the impact on her husband, demonstrating that miscarriage also affects partners and families in emotional ways, the variety of quotes also shows that the impact can be more varied. For example, Cox includes her husband in her own emotional response — “we bounce back quickly” — while Brinkley focuses on the fact that her husband has told her he would be happy without a baby. Rauch’s essay, which also uses an episodic frame, also includes the impact on her husband. However, she goes a bit further by including some general context about miscarriage, including miscarriage statistics: “Due to reasons beyond anyone’s control, miscarriage is estimated to occur in anywhere from 15 to 20 percent of recognized pregnancies” (para. 8).
Overall, the framing choices to include husbands, fathers-in-law, etc. suggests to readers that family might be involved in a pregnancy loss. However, the lack of other sources, educational resources, or broader context discourages readers from viewing pregnancy loss as something that can be affected at the societal level through research, public policy changes, or treatment. This is supported by research that finds, at least for political issues, the type of framing effects “how individuals assign responsibility” for an issue (Iyengar, 1991, p. 15). Episodic framing tends to “elicit individualistic rather than societal attributions of responsibility, while thematic framing has the opposite effect”
(Iyengar, 1991, p. 15). Entman (2004) also supports this idea. He writes that procedural framing “does little to motivate or equip the public to engage in political deliberation” (p.
6). Therefore, the episodic framing of these articles on miscarriage is likely to encourage readers to think of pregnancy loss as a sad event that a woman can suffer; whereas a thematic frame that includes more of the type of information shared by Rauch and
32 additional broader context could better encourage public dialog and action on miscarriage research, education, and treatment.
Use of familial language over clinical terms: The news coverage examined here uses language such as “baby,” “family,” and “pregnancy” instead of medical words and phrases such as “embryo,” “fetus,” or “spontaneous abortion” — the commonly used term for miscarriage in medical practices and medical literature (National Institutes of
Health, 2020). These framing choices encourage readers to think about miscarriage in humane terms focusing on the life and future lost. The framing also conforms to societal expectations about women desiring children.
In the article on Bertinelli, the actress exclusively uses the language of “baby.”
She is directly quoted as saying: “Goddamit, I wish we hadn’t lost the baby…” (para. 5) when reflecting on her wish that he father-in-law could have met his grandchild. The article also includes a paragraph with a direct quotation from Bertinelli that she did not want to “dwell on losing the baby”:
Like her husband, who found his escape in Van Halen’s 97-city tour, Valerie
grabbed at I’ll Take Manhattan. “I was planning on drowning my sorrows, not
working, so Manhattan came along at the perfect time,” she says. “Maxi was the
perfect part for me after what I’d been through. I could dress up, put on makeup,
get my nails done and wear glamorous clothes. I didn’t want to dwell on losing
the baby.” (para. 6)
Additionally, the magazine echoes the familial language, noting in the headline that
“Bertinelli gets her sexiest role yet, but she’d rather be a mom.” The reporter also states
33 Bertinelli is trying for another baby, wants “two or three children,” and closes the article by stating a baby would be “icing on the cake” when it comes to her life:
While the world imagines a wild rock life for Mr. and Mrs. Edward Van Halen,
spiked with fights and red-hot sex, the actress provides a glimpse of the real
picture: On a typical homey evening, says Valerie, she and Eddie play video
games until bedtime. Then, “I start reading. Ed falls asleep. Then I put the book
down, turn off the light and the cat crawls under the covers.” The description
makes Valerie smile. A baby would be the icing, but she’s happy with her life this
way. (para. 17)
The article on Brinkley also uses the baby language. The reporter writes that “Brinkley wanted nothing more than to cement their union with a baby of their own” (para. 8).
Brinkley also is quoted directly as saying: “Four months is a lot of living with that little life in you” (para. 7). The article on Cox is similar: the reporter writes about “their ongoing attempts to have a baby” (para. 7) and to “start a family” (para. 13).
Additionally, the article quotes a family member, who uses the words “baby” and
“parents,” in a paragraph that also quotes Arquette:
“They're determined to have a baby.” For obvious reasons, says Arquette’s sister
Rosanna, “Davey’s the kind of guy who will dress up in a bear costume to read
Goldilocks. They're going to be incredible parents.” Neither is ready yet to
discuss possibilities such as surrogacy or adopting. But nothing, says Arquette, is
out of the question: “We’ll look into any option we need to in the future.” (para.
14)
34 The subhead on Rauch’s essay references her “long road to parenthood.” The actress uses phrases such as “our baby” (para. 5), “little bundle” (para. 3), and “my future child”
(para. 6). She also notes that she and her husband stopped using the word “miscarriage”:
It’s not that a better name would make it less awful to go through. But for a while,
my husband and I just started saying to each other — without any judgment or
acrimony to the baby, of course — that the baby “bailed” instead. (para. 7)
Rauch also humanizes her loss by discusses seeing the image of her baby without a heartbeat:
The image of our baby on the ultrasound monitor — without movement, without a
heartbeat — after we had seen that same little heart healthy and flickering just two
weeks prior completely blindsided us and haunts me to this day. (para. 5)
The framing choices — exclusively using terms like “baby” over clinical words like “fetus” — is consistent with the reality in Western society that the social birth of a baby now often precedes its physical birth due to changing social norms and advances in medical imaging technology in recent years (Morgan, 1996). Parents can now see their baby through ultrasound images and videos, display those pictures for friends and family, learn the gender and give the baby a name before ever giving birth (Morgan, 1996). The
“greater social value” (p. 59) assigned to fetuses is especially true when couples wanted and planned for the baby, and even more when they pursued fertility treatments to achieve the pregnancy (Morgan, 1996). This means parents see their unborn child as a person, which affects their experience with miscarriage (Andipatin et al., 2019). In the media, the choice of what language to use when discussing miscarriage is especially important because past research has demonstrated the power of such framing in
35 determining public opinion. Simon and Jerit (2007) showed that when articles used the word “baby,” public support for the partial-birth abortion ban increased. However, articles that only used the word “fetus” did not generate as strong a level of support for the abortion ban in their experiment (Simon & Jerit, 2007). Language use is also at the heart of the stem cell research debate and how it is presented in the media. Proponents of stem cell research focus on researching “microscopic” “pre-embryos” or “blastocycles”
— “balls of cells” which can be used in the first 14 days after fertilization and are not yet considered true embryos, while opponents of research focus on embryos as “unique” and
“human” that should be “cherished and protected” (Williams et al., 2003, p. 802). The framing of miscarriage as the loss of a baby encourages readers to view it in an emotional way as the loss of a life and a future wanted member of a family. The reporters’ use of the term baby and the use of direct quotations of women discussing their future hopes and dreams for their families encourages sympathy for the woman and her partner, without triggering any political debate over at what point a fetus is considered a human being.
The use of familial language also coincides with research that finds miscarriage is sometimes tied to what people generally consider public information, including whether a woman has children or plans to have children (Bute, 2009). When Bute interviewed women who had experienced miscarriage, they shared that they sometimes disclose pregnancy loss to people outside their close circles of intimacy, such as coworkers and even strangers, in order to avoid the social stigma that is connected to a woman deliberately choosing not to have children. The framing of miscarriage as the loss of a baby, instead of a fetus or embryo, in these articles follows that research finding,
36 demonstrating that these celebrities are conforming to social norms in attempting to have children.
The use of this familial language, along with the episodic framing and the display of clear emotional effects of miscarriage in the articles, demonstrates that the primary function of the media coverage of miscarriage is to generate empathy. Generating empathy is one of the “core functions” of media in a democracy (Craft & Davis, 2016, p.
11). Empathy is the “ability to identify what someone else is thinking or feeling and respond to their thoughts and feelings with an appropriate emotion” (Baron-Cohen, 2011, p. 11). It involves two steps: identifying someone’s emotions and responding to them
(Baron-Cohen, 2011). Generating empathy is tied to the media’s core function of creating public norms (Craft & Davis, 2016). Public norms, also known as social norms, are
“actions or beliefs commonly accepted as normal behaviors by a group or society”
(Lundin, 2019, para. 1). In the case of media coverage of miscarriage examined here, the framing suggests these social norms include grieving the loss of a pregnancy privately without a ritual such as a funeral, experiencing emotion personally and with family, and keeping medical details private. Generating empathy and creating public norms are important roles for the media because culture is “a crucial dimension of our citizenship that requires nurturing and reflection” (Christians et al., 2009, p. 167). Media coverage that generates public empathy can weave community together by sharing “narratives that invigorate their common understanding of good and evil, happiness and reward, the meaning of life and death” (Christians et al., 2009, p. 169).
Missing medical details: The articles focus more on each woman’s desire for a family than medical causes or outcomes of miscarriage. None discuss the medical reason
37 for the miscarriages — or, as may be the case, the fact that no medical diagnosis, such as a chromosome abnormality, tubal pregnancy, etc., could be determined for the loss. None discuss the physical recovery, including whether the celebrity required medical intervention, such as a dilation and curettage (D&C) procedure. None discuss medical risks to the mother, including the risk of infection or even life-threatening hemorrhage.
The absence of this content leaves silent a major part of the miscarriage experience. It also discourages readers from thinking about miscarriage in medical terms that might be addressed at the societal level through advances in research or health policy changes. It also is noteworthy because Bardos et al. (2015) note that more women feel guilt about a miscarriage when a cause for the loss is not given, so addressing this reality in articles could help women better understand and possibly avoid that emotion.
Some of the articles do indirectly suggest that a medical diagnosis could not be made. The reporter writes that for Bertinelli, “the whys of the failed pregnancy haunt her”
(para. 7). Additionally, Brinkley suggests a diagnosis was not made when she is quoted directly as saying that after her first miscarriage she assumed it was not “meant to be”:
I tried to take the attitude that it was my body’s way of telling me that this
pregnancy wasn’t meant to be and that it was better for everybody… But after the
second one, it was really devastating… After the second one, we decided to try in
vitro, because both Peter and I felt we couldn’t handle another failure. We
thought: Let’s let the best of science try it for us. When I miscarried after that, we
had to come to terms with the possibility that this wasn’t meant to be. It’s just
amazing that two months later I got pregnant again. (para. 7)
38 Additionally, in the article on Cox, the actress says she gets pregnant easily but cannot sustain the pregnancies, without further explanation. The article does not state how many miscarriages Cox has experienced, but quotes Cox as saying it has happened “quite a few times” (para. 7). Rauch’s essay also suggests she did not receive a medical reason for her miscarriage. She writes:
I knew in my heart there wasn’t anything I could have done to prevent what
happened, but that didn’t stop me from the futile exercise of mentally replaying
every day of the pregnancy up until that point over and over again, wondering
whether there was something I did that could’ve caused the miscarriage. (para. 6)
Other medical aspects of miscarriage and fertility are also discussed, but without substantial detail. For example, the reporter writes that Brinkley has experienced
“pregnancy traumas” (para. 31) and uses the quote noted above from the actress on her decision to pursue in vitro fertilization to achieve a healthy pregnancy. The article, however, does not explain why or how IVF would increase her chances. In direct quotes,
Cox references the medical consensus that it is more difficult for a woman to have a baby later in life — the risk of miscarriage increases after age 35 (Mayo Clinic, 2021) — but the article does not provide medical information to support or explain this fact. The increased risk associated with advanced maternal age also is not noted in the article on
Brinkley, who was 44 years old (and pregnant) at the time the piece on her was published. The only information on the increased risk of negative pregnancy outcomes after age 35 in any of the articles is from Cox in direct quotes: “I don’t know if you're ever ready for kids. But I wasn’t getting any younger” (para. 13). The article on Cox continues:
39 The couple are cautiously optimistic about trying IVF again. “It’s a fact that after
a certain age you have less of a chance,” says Cox. Her mother gives her “advice
about being patient,” says Copeland, “but knowing C.C., she’s going to get
information from every doctor and specialist. They’re determined to have a
baby.” (para. 14)
As it was with the emotional effects of miscarriage, Rauch in her first-person essay goes further in discussing medical details by sharing how she wishes she had known to ask doctors for help in addressing the hormonal drop-off that follows miscarriage:
During this time I was continually surprised by the constant assault of emotions—
and how severely unlike myself I felt. In addition to the intense grief, the
hormonal drop-off is something I was not prepared for in the least. I wish I had
known that this physiological response is an extremely prevalent and real
component of pregnancy loss. In retrospect, it would’ve helped me to be aware
that many women essentially go through a form of postpartum depression after a
miscarriage, without a baby to show for it. If nothing else, having this knowledge
may have put some of my darker “what the shit is happening” moments in context
for me. (para. 9)
While the omission of more medical information can be viewed as an important missing element for helping women understand miscarriage, it also could be reflective of these celebrities’ decisions to protect some of the private information they own (Petronio
& Steuber, 2014). By not sharing these details, they might be helping themselves feel less vulnerable (Petronio & Steuber, 2014). The absence of this information also could be consistent with research findings that women are sometimes uncomfortable with
40 language associated with miscarriage that is used by their doctors, including the “loaded and graphic language providers used to describe the medical aspects of miscarriage and management options” such as the term “suction” when discussing a D&C (Brann et al.,
2020, p. 265). Media outlets may follow women’s preferences for avoiding discussion of these aspects of their experiences. This could be important as the coverage serves a second core function in addition to generating empathy. The second function is to create a public conversation (Craft & Davis, 2016). The celebrity and beauty magazines that published the articles examined here reach millions of readers, mostly women, both in print and online. For example, People Magazine has a 96 million-person audience, including one in two moms (People Magazine, 2020), and Good Housekeeping has nearly
17 million readers, of which 87% female (Good Housekeeping, 2020). The coverage also spurred social media posts and articles in other news outlets. The magazines may wish to conform to social norms about avoiding medical details which make even patients uncomfortable. However, for readers, the framing of these articles that excludes clinical details creates a window on miscarriage that blocks their view and understanding of a major part of what is ultimately a medical experience as much as an emotional one.
41 DISCUSSION
The purpose of this textual analysis was to examine media framing of miscarriage experienced by celebrities to better understand what messages readers receive about pregnancy loss. Miscarriage framing is understudied in communication literature. It is important to examine because news coverage can be a main way women glean information about what to expect following a miscarriage. The topic remains taboo in modern society because of public norms surrounding death (Bansen & Stevens, 1992), even though a large, and increasing, number of women will experience such a loss in their lifetimes (Curtin et al., 2013). In fact, due to advances in home pregnancy tests, more women are aware of miscarriage than in the past — the rate of reported losses generally increasing 1% each year in the United States (Lang & Nuevo-Chiquero, 2013).
Still, as a result of the silence surrounding pregnancy loss, women are often unprepared for the emotional reaction they experience (Broquet, 1999), including feelings of guilt, isolation, depression, and stigma (Bansen & Stevens, 1992; Bardos et al., 2015;
Bommaraju et al., 2016; Broquet, 1999; Madden, 1994; Whiteford & Gonzalez, 1995).
This analysis involved four articles, published between 1987 and 2017, that feature extensive discussion of the celebrity miscarriage, including direct quotations from the women. The analysis of the media framing shows that while the coverage served the core functions of news of generating empathy and creating a public conversation, the framing still may be inadequate in many ways. The articles often failed to fully communicate the experiences of women who have lost a pregnancy, including the full range of emotions they may go through as well as the medical realities they may have to
42 face. The episodic framing of these pieces also left out broader context that could cause readers to evaluate pregnancy loss as a public health issue that could be positively affected at the societal level through education, research, or public policy changes. These findings can help to inform future newsroom conversations about how to cover the topic of miscarriage, including on the importance of considering a thematic frame that would include expert sources and links to educational materials. The themes identified in the news coverage also can help health care providers, as well as members of the general public, by providing a baseline understanding of what information women have received, and not received, through some coverage in popular magazines to better understand gaps that may exist in their knowledge of miscarriage, including its causes, frequency, and the emotional and clinical realities it can bring.
RQ1 focused on the themes present in news articles covering celebrity miscarriage. Four themes were identified across the news coverage. The first is that the articles clearly demonstrate that miscarriage is an emotional event for a woman. This is meaningful because literature has established that family, friends, and health care providers often do not appreciate the level of emotion some women experience following a loss. The stories written by reporters use descriptions, including words such as
“heartbreaking” and “nightmare,” to describe pregnancy loss, along with extensive direct quotations from the celebrities to convey the emotional effects they felt. The number of times and variety of ways the articles express emotions makes this aspect of miscarriage salient to readers. Extensive coverage of this aspect of miscarriage could help advance social norms that sometimes keep women from disclosing their miscarriage even to their family, and it could help family, friends, and others with insight on what their loved one
43 might be feeling after the loss. It must be noted, however, that the reported articles only reflect that the celebrities felt sadness. Other emotions commonly found in miscarriage literature are left out. By contrast, actress Melissa Rauch in her first-person essay names depression, isolation, stigma, and guilt as outcomes of her pregnancy loss. Depression, isolation, stigma, and guilt have been found across many miscarriage research studies, including several published in the 1990s. In literature, women acknowledge that the societal silence surrounding miscarriage that keeps them from openly discussing their losses can be a major contributor to these feelings, especially isolation (Bellhouse et al.,
2018). It is noteworthy, then, that only the newest article examined in this study —
Rauch’s 2017 essay — names these outcomes. While scholars have been aware for some time that women experience guilt, isolation, stigma, and depression following miscarriage, media framing only now may be catching up. Framing that makes the public more aware of these outcomes may help lessen the feelings of isolation, stigma, and guilt that women experience. The distinction that Rauch’s story is told through a first-person essay, as opposed to a reported article, could be important. It suggests that in covering celebrity miscarriage through traditional means — a reporter interviewing an actress and then writing about it — magazines may more closely adhere to public norms surrounding a taboo topic. In this case, although the magazines are breaking with social norms by publishing about miscarriage, it is possible they are leaving out some details of the experience which could be considered more severe, such as depression. With greater editorial control through a first-person essay, Rauch takes the narrative further — detailing how her loss “kick-started a primal depression” (para. 5) and caused her to experience guilt and shame. Rauch’s decision to go into more depth about the emotional
44 fallout of her loss suggests that women may be ready for social norms surrounding how miscarriage is discussed to be more open about the emotional experience.
The second theme identified is the use of episodic framing. All four articles employ an episodic frame focused on telling the individual woman’s story without any additional broader context on the topic of miscarriage. The episodic framing is not unexpected because the majority of news stories use this frame due to the demands of filling a daily or weekly news hole (Iyengar, 2005). One could argue it is further expected from celebrity and beauty magazines, which were the sources of the articles examined in this analysis. For example, People’s mission statement tells readers, in part, their magazine takes you “inside the lives of the world’s most intriguing people.” This suggests that their goal is to tell stories focused on individuals. However, their mission statement also includes the magazine’s aim to “drive conversation and inspire action” and
“enrich your life with indispensable service and social connection,” which one could argue makes a thematic frame, which lends deeper understanding on a topic, important.
The episodic framing used across the four articles examined reinforces the public norm that pregnancy loss is an individual experience; whereas, a thematic frame — with broader context, expert sources, and educational links — could cause readers to evaluate pregnancy loss as a public health topic instead. This can be said because research has established that framing can affect how people assign responsibility. Therefore, episodic framing used in this miscarriage coverage encourages readers to associate miscarriage with the individual — a sad experience for this one woman, but little effect on themselves or the general public beyond that. A thematic frame can encourage readers to assign responsibility at the public level, meaning they might view miscarriage as an issue that
45 deserves more attention at the societal level through increased public discussion, education, research, etc. It is also important to note the episodic framing used in this miscarriage research because public understanding of miscarriage is low, including even basic knowledge on what causes a loss (Bardos et al., 2015). Due to this lack of understanding, many women blame themselves for the loss even though chromosome abnormalities, which happen by chance and cannot be prevented, are the cause of almost half of miscarriages (Cleveland Clinic, 2019). Misinformation surrounding fertility has even affected politics in recent years, including the introduction of two bills in the Ohio
Legislature suggesting doctors can reimplant embryos that are ectopic (outside the uterus) to save the pregnancy, which is not medically possible (Associated Press, 2019). More media coverage of miscarriage using thematic framing could improve education on the topic, dampen the taboo surrounding it, and drive the public conversation — as well as public policy — forward.
The third theme is use of familial language instead of clinical terms. This is demonstrated through the articles’ exclusive use of words such as “baby” and “family” and the absence of medical terms such as “embryo” or “fetus.” The framing suggests that for the celebrities — in this analysis, all married women who were intentionally trying to grow their family — the loss of the pregnancy is viewed as the loss of a wanted child.
These framing word choices encourage readers to also view miscarriage as the loss of human life and future family. Although social norms do not generally include a funeral or bereavement for miscarriage, this framing grants some recognition of the grief and mourning that women experience. The consistent use of familial language across these articles also stands in contrast to media framing of other issues that involve pregnancy
46 and childbirth. Examples include abortion and stem cell research, which are typically framed to include two sides—opponents who use human language and proponents who favor medical terms. The distinction that miscarriage coverage exclusively uses familial language further suggest that miscarriage is viewed in society as a private, emotional event for a woman rather than an issue to be discussed or debated in the public or political arenas.
The fourth and final theme is missing medical details. The analysis of the four articles revealed that none discussed the medical aspects of miscarriage. An important example of this is that the coverage did not include whether or not a diagnosis could be made for the loss. Diagnosis could include a chromosome abnormality, uncontrolled diabetes, thyroid disease, ectopic implantation, etc. (Cleveland Clinic, 2019).
Additionally, none of the articles revealed whether or not the celebrity required medical intervention, such as medication or surgery, to complete the miscarriage. Framing acts as a window, and by eliminating the medical realities of miscarriage from the frame, news media ignore a major part of the miscarriage experience. This omission is important because the media can influence health behaviors. In the case of miscarriage, women should know they may need to see a health care professional for miscarriage to ensure they are not at risk of infection or hemorrhage. Women also should be prepared to make decisions about their treatment, including whether they wish to complete the miscarriage naturally or speed the process with medicine or surgical intervention. Additionally, they should know the risk of miscarriage increases substantially with age. The silence on medical issues is not unexpected given the stigma that surrounds miscarriage. Its absence
47 from the news articles examined for this study also could be the result of women’s attempts to protect some of their private health information and avoid feeling vulnerable.
RQ2 focused on the primary function the framing serves in these articles. This analysis finds that the miscarriage coverage fulfills two of the primary functions of the media: to generate empathy and create public conversation (Craft & Davis, 2016). These functions are especially important given the taboo nature of miscarriage. Across miscarriage literature, women report that the silence that surrounds miscarriage contributes to and heightens their feelings of isolation, guilt, and stigma. Because of the social norms around grief and death in the United States, they are not able to openly discuss their loss. And when they do discuss it, friends and family are not prepared to respond. Media organizations have the power — by creating a public conversation and generating empathy — to influence the social norms surrounding pregnancy loss in ways that will help prepare readers to discuss it and respond empathetically. This power depends on people reading their magazine and taking an interest in the story, and it is not guaranteed. While media suggest a certain meaning through framing (Iyengar, 1991), it does not guarantee that readers will receive the message in that way (Entman, 1993). It also should be noted that the articles in this analysis feature only white women and are published by magazines based in the United States; however, the sigma of pregnancy loss exists worldwide. The World Health Organization in 2019 launched a website, “Why we need to talk about losing a baby,” with stories from women around the world and resources including what loved ones should and should not say to be supportive. The website notes, “As varied as the experience of losing a baby may be, around the world, stigma, shame and guilt emerge as common themes” (para. 3). Although these common
48 themes emerge, it is also true that social norms, rate of diagnosis, treatment protocols, and attitudes about miscarriage vary greatly by culture. The WHO notes, “In sub-Saharan
Africa, a common belief is that a baby might be stillborn because of witchcraft or evil spirits” (World Health Organization, 2019, para. 4). This belief would have a dramatic effect on miscarriage attitudes and likely media coverage of the topic. Therefore, a global analysis of news articles about miscarriage could yield different findings than this study.
In the United States, by sharing the stories of celebrities who have miscarried, thereby creating a public conversation and generating empathy on the topic, the magazine articles examined here take important steps in addressing the societal silence and taboo nature of pregnancy loss. Media has the ability to shape public norms. This analysis of coverage reveals that the way media have framed these stories suggest that public norms surrounding miscarriage included experiencing an emotional reaction, grieving with family over the future and dreams lost, and keeping medical details private. Additionally, the social norms could include deciding to disclose miscarriage as proof of a woman’s attempts to fulfill expectations that she have children.
RQ3 asked whether the framing of celebrity miscarriage has changed over time.
The articles examined spanned 30 years from 1987 to 2017. Although popular media and literature began increasingly addressing miscarriage starting in the 1980s (Madden,
1994); there is widespread recognition that the topic remains taboo. It was somewhat surprising, then, that the three reported articles, published between 1987 and 2003, did not include any reference to the stigma associated with miscarriage. In fact, there is little variation in the framing of the articles published on Bertinelli, Brinkley, and Cox. When considering RQ3, the strongest suggestion that miscarriage framing may be changing
49 over time comes from Rauch’s first-person essay. Of the four articles examined, hers is the most recent, published in 2017. Although it is difficult to generalize across time based on four articles, it is noteworthy that not only is Rauch’s essay the only one of the four to include references to depression and other themes found in many studies involving women who have experienced miscarriage — she is the only of the celebrities to name the social stigma attached to pregnancy loss. This is important because recognizing the stigma and publicly discussing it are key ways that social norms surrounding a taboo topic can change. Women’s health topics have undergone evolving social norms — breast cancer, for example, was once considered a “dirty little secret” (Thorne & Murray,
2000, p. 143) but is now more openly discussed. Rauch’s decision to name the stigma and write about her hope for how the discussion around miscarriage might change in the future suggests that miscarriage may be undergoing a similar evolution — perhaps not in the lives of everyday people, but at least in the media.
Limitations: As a qualitative textual analysis of four articles, this study is limited by its small sample size. Media framing of miscarriage remains understudied. With limited analysis, especially qualitative analysis, in this area this study can be considered a first step toward exploring this topic and building an understanding of how media frame pregnancy loss and what messages that framing sends to readers. This study should be expanded and built upon. An analysis of a larger number of articles on celebrity miscarriage could reveal additional insights on the messages readers receive about miscarriage from popular media. Further, this study exclusively examined articles published in one medium: celebrity and beauty print magazines. Studies of articles in daily newspapers, online publications, or broadcast television could lend different
50 findings. This could be especially true for live television interviews. Visible displays of emotion by celebrities could impact the interviewer and the audience in ways that do not come across in print. Additionally, the articles examined in this study were all from publications based in the United States. Media coverage in other countries could be affected by cultural norms specific to those areas, impacting the framing and the messages audiences receive. All of the celebrities who made disclosures examined in this study are white; health issues can affect minority women differently, which could influence their experience with miscarriage. This study also examined only disclosures by women; a review of coverage of disclosures made by male celebrities whose wives, or perhaps surrogates, experience miscarriage could lend different findings.
Future research: Framing of miscarriage is ripe for future research. Scholars could examine the messages women receive about miscarriage through several avenues.
This research study could be extended to include more recent coverage because more celebrities are announcing their losses every year. In 2020 alone, model Chrissy Teigen shared her loss first on social media and then in an essay on Medium, British royalty
Meghan Markle wrote an op-ed in The New York Times, and many others discussed their miscarriages publicly (Cho, 2019). Examining newer media articles could further reveal whether any changes in social norms surrounding miscarriage are evident, or whether media coverage is evolving to include more thematic framing. Scholars also could further explore media framing of miscarriage by analyzing articles in popular outlets that are written about or by regular women instead of celebrities. This could provide further insight on when and why women choose to publicly discuss what is still considered a taboo topic. The distinction would be important, as celebrities have less expectation of
51 privacy than do private citizens. Research also could be extended with other methods, including quantitative analysis of a large number of articles, broadcasts, etc. Methods also could include surveying readers to determine whether miscarriage coverage has an effect on them, including their basic understanding of aspects such as frequency, causes, etc. Surveys could also possibly test for effects due to differences between episodic and thematic framing. Scholars also could expand the area of study beyond media framing, as many celebrities choose to disclose their losses on social media, personal websites, in memoirs, and through other means. An analysis of this type could provide an important distinction between how media covers miscarriage and how women discuss it in non- mediated venues.
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