Newspaper Framing of Postpartum Depression: Impact of the Andrea Yates Case

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Newspaper Framing of Postpartum Depression: Impact of the Andrea Yates Case
Schmid, Laura A.
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Copyright 2004 by Laura A. Schmid


I would like to dedicate this thesis to Andrea Yates and her five children.


ACKNOWLEDGMENTS I most especially would like to thank the following: My advisor, Debbie Treise, for all of her much-needed guidance and encouragement—she has been a true mentor. I’ll go flying with her anytime! My committee members Kim Walsh-Childers and Mike Weigold—Kim’s thorough editing of my papers and advice, both personal and scholastic, has been absolutely invaluable, and Mike’s thought-provoking class discussions and comments have expanded my way of thinking about the world around us. My parents, for their ever-lasting faith and support of me, both personal and financial. My siblings, for putting up with my major end-of-term research-paper stress attacks. My personal computer helpdesk experts—Stephen B. Wright, Mickey Desai, and Gary Lyons. Without their cheerful and mocking aid, my computers would have been ditched out the window years ago. My friends, for aiding and abetting my social life, and keeping a smile on my face throughout my graduate school career. My best friend for all time, Debi Springer, for keeping me true to myself. Words can never express how much her steady empathy, assurance, and love have inspired me and kept me on my life path’s track. iv


And most of all I thank my children—my kitties, Mowgli and Fiona, for putting up with my constant moves and neglect during my graduate school career, especially during this thesis process. They have loved me anyway, and still remain the coolest, friendliest, and most affectionate cats around! v


TABLE OF CONTENTS page ACKNOWLEDGMENTS.................................................................................................iv LIST OF TABLES...........................................................................................................viii ABSTRACT.......................................................................................................................ix CHAPTER 1 PURPOSE AND SIGNIFICANCE OF THE STUDY.................................................1 2 LITERATURE REVIEW.............................................................................................6 The Andrea Yates Story................................................................................................6 Other Postpartum-Related Maternal Filicide Cases.....................................................9 The Postpartum Depression Issue...............................................................................11 The Medical Angle..............................................................................................14 The Legal Angle: The Insanity Defense.............................................................18 Framing Theory..........................................................................................................20 Media Framing by Stakeholders.................................................................................23 Research Questions.....................................................................................................25 3 METHODOLOGY.....................................................................................................26 Newspapers.................................................................................................................26 Time Frame.................................................................................................................27 Search Terms..............................................................................................................28 Article Criteria for Content Analysis..........................................................................29 4 RESULTS...................................................................................................................32 Research Question 1: How Do Newspapers and Stakeholders Define PPD?...........34 The Chicago Sun-Times......................................................................................38 The Chicago Tribune...........................................................................................41 The Houston Chronicle........................................................................................45 The New York Post.............................................................................................47 The New York Times..........................................................................................48 vi


The St. Petersburg Times....................................................................................48 USA Today..........................................................................................................50 Stakeholder Definitions.......................................................................................51 Research Question 2: How Have the Media Framed PPD in the Recent Controversy and Coverage Stemming from the Andrea Yates Case?........................................54 The Battle Frame.................................................................................................55 The Blame Frame................................................................................................57 The Jekyll and Hyde Frame.................................................................................61 The Legal Frame..................................................................................................64 The Medical Frame..............................................................................................65 The Society Frame...............................................................................................67 The Storyteller Frame..........................................................................................75 Research Question 3: How Does Framing during and after the Andrea Yates Event Compare to Previous Framing of PPD?.................................................................76 Framing before the Andrea Yates Event.............................................................77 Framing during the Andrea Yates Event.............................................................79 Framing after the Andrea Yates Event................................................................80 Research Question 4: Did National Newspaper Coverage Differ from Local Coverage of the Andrea Yates Case?.....................................................................82 5 DISCUSSION.............................................................................................................88 Practical Implications of This Study.........................................................................100 Limitations of This Study.........................................................................................102 Suggestions for Future Research..............................................................................104 Conclusion................................................................................................................106 APPENDIX A CODING SHEET.....................................................................................................108 B DESCRIPTIVE INFORMATION ABOUT ARTICLES.........................................110 LIST OF REFERENCES.................................................................................................111 BIOGRAPHICAL SKETCH...........................................................................................124 vii


LIST OF TABLES Table page 4-1 Articles coded and articles defining PPD..............................................................34 4-2 Dates of articles defining PPD...............................................................................37 4-3 Frames....................................................................................................................54 4-4 Main topics of national (elite) newspaper articles.................................................83 4-5 Main topics of local (non-elite) newspaper articles...............................................83 B-1 Descriptive Information about Articles...............................................................110 viii


Abstract of Thesis Presented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Master of Arts in Mass Communication NEWSPAPER FRAMING OF POSTPARTUM DEPRESSION: THE ANDREA YATES CASE By Laura A. Schmid May 2004 Chair: Deborah M. Treise Major Department: Mass Communication A Texas mother, Andrea Yates, methodically drowned her five children on June 20, 2001. She suffered from postpartum psychosis, the most extreme form of postpartum depression. The subsequent media coverage brought to the forefront of the American public recognition of a mental illness that has begun to be understood only recently. Seven U.S. newspapers were examined to determine how they framed postpartum depression before, during, and after the Andrea Yates case occurred. Three newspapers were national or elite newspapers: Chicago Tribune, The New York Times, and USA Today. Four newspapers were local newspapers: Chicago Sun-Times, The Houston Chronicle, The New York Post, and St. Petersburg Times. A sample size of 256 articles was analyzed for key terms, catch phrases, figures of speech, and themes that recurred frequently. The newspapers discussed the issue of postpartum depression very little, compared to the substantially increased amount of coverage of the Andrea Yates case. There was ix


inconsistency and wide variation across the newspapers in how postpartum depression was defined and which aspects were highlighted. Stakeholders who were quoted most often included medical and legal experts, advocacy group members, and members of the general public, such as family, friends and neighbors of Andrea Yates. Seven major frames were found: Battle, Blame, Jekyll and Hyde, Legal, Medical, Society, and Storyteller. Generally, the Storyteller and Medical Frames were used most frequently across all the newspapers. Coverage of postpartum depression was minimal or nonexistent before the Andrea Yates case, except for local postpartum-related cases of mothers who committed suicide or infanticide. Coverage peaked after the Yates children’s drownings and during Andrea Yates’ trial; but dropped back almost to the pre-Yates level after the trial was over. On average, local was higher than national newspaper coverage of the Andrea Yates case. The newspapers not only framed postpartum depression in specific ways, but these frames shifted over time. Journalists tended to simplify the postpartum depression issue and often only spotlighted certain aspects of it. The increased attention to the issue of postpartum depression did not last, so the long-term effects of the increased news coverage are questionable. However, the mass media can make a significant impact on how postpartum depression is perceived by policy-makers and the general public by the way they frame this issue. x


CHAPTER 1 PURPOSE AND SIGNIFICANCE OF THE STUDY A Texas mother, Andrea Yates, apparently suffering from postpartum psychosis (a severe form of postpartum depression), methodically drowned her five children on Wednesday, June 20, 2001. In February of 2002, she faced trial and later was found guilty of two counts of capital murder and sentenced to life in prison (with the possibility of parole after 40 years), despite a defense using the insanity plea. The subsequent media coverage of these events brought to the American public forefront recognition of a mental illness that has begun to be understood only in the past two decades. Postpartum depression (PPD) and its varying levels of manifestation as defined today is seen as a relatively new and controversial mental illness, despite the fact that postpartum psychosis (PPP), the most acute level of PPD, first was described by Hippocrates (the ancient Greek physician) more than 2,000 years ago in the fourth century BC (Pariser, Nasrallah, & Gardner, 1997) . Three types of postpartum psychiatric disorders (often referred to as mood disorders by many mental health practitioners) are recognized: maternity or baby blues, postpartum depression, and postpartum psychosis (Martinez, Johnston-Robledo, Ulsh, & Chrisler, 2000) . Postpartum depression has been linked to infanticide1 cases. Postpartum psychosis, the most extreme form of PPD, has been blamed for some two dozen babies’ deaths in the United States in the past 20 years (Anderson, 2001, June 22). 1 Most definitions of infanticide note that it is the practice of intentionally causing of the death of an infant or a young child. No age limit for a child was found for a death to be ruled an infanticide. 1


2 This increased awareness and coverage of PPD, as well as the controversy about its underlying causes and its role in infanticide, point to the importance of taking a closer look at what exactly is and is not known about PPD, as well as how reporting in the national media may be shedding light on or increasing confusion about this highly charged topic. Several different groups have an important stake in how PPD is portrayed by the media and perceived by the general public: members of the medical profession, the legal arena, and advocacy groups (such as feminist or victim’s rights groups). Each of these stakeholders thus attempts to influence how PPD is framed in the media to parlay their particular points of view. Framing occurs when media coverage is selectively construed so as to evoke particular images and references for readers, as well as to influence opinion by stressing specific values and facts and promoting a particular definition of a problem. Framing analysis of media is a useful technique for evaluating print materials. Because news media have selected and emphasized certain aspects of the issues surrounding PPD, it is important in determining what the public has learned from this increased coverage, what medical and public policy changes may be made that may affect the diagnosis and treatment of women suffering PPD, what legal precedents may be set, and what changes may need to be made in media coverage of PPD. As Martinez et al. (2000) point out in justifying their content analysis of magazine articles about PPD, research such as this is important theoretically because it can document and illuminate the social construction of women’s health issues; and is important clinically because it is helpful for health care practitioners to know what their patients are likely to know or believe about PPD.


3 Thus, the purpose of this study is to take that closer look, akin to putting a magnifying glass to fine print, in an effort to take a virtual snapshot of the state of our national understanding of PPD, and how national newspaper coverage and stakeholders’ framing are influencing that understanding. This snapshot can show what progress has been made, how it has been shaped, and what the implications are for future public policy dealing with PPD. Media coverage can play an important role in the debate over the medical, legal, and political ramifications of PPD. The media are major sources of information about health and illness for most people, and thus play an important role in the shaping of health beliefs (Martinez et al., 2000) . The media often cover certain events and circumstances that are deemed newsworthy because of their unusualness. As Birkland (1998) noted, many social scientists have cited the importance of sudden, attention-grabbing events (known as focusing events) in advancing issues on the agenda and as potential triggers for policy change. A focusing event is an event that is sudden, that is relatively uncommon, that can be reasonably defined as harmful or revealing the possibility of potentially great future harms, that has harms that are concentrated in a particular geographical area or community of interest, and that is known to policy makers and the public simultaneously. Birkland also observed that journalists often claim that focusing events concentrate attention on previously dormant issues. The Andrea Yates case served as a focusing event for bringing attention to PPD, an issue mostly ignored by policymakers and the general public. Postpartum depression is often overlooked and untreated; and its causes are still not well understood (Georgiopoulos, Bryan, Wollan, & Yawn, 2001) . In fact, much of the


4 controversy surrounding PPD stems from arguments over the likely factors (which are believed to stem from biological, environmental, and/or cultural causes). Some researchers question whether PPD is even a legitimate syndrome, arguing that symptoms are the same as depression at any other time or stage in a person’s life. Disagreement over the most effective treatments also exists. The stigma of a mental illness persists in American and other societies, especially surrounding a circumstance that is supposed to be as joyous and fulfilling as motherhood. This has led to shame on the part of those suffering mood disorders, confusion over what PPD is, and disputes over the best way to view and treat mothers suffering from this disorder, especially those who commit infanticide. In the United States, no national standard exists for trying cases of infanticide linked with PPD as there is in Britain, where postpartum psychosis is a defense for infanticide until a child is 2 years old (Anderson, 2001, June 22) . In the legal drama that has unfolded from the Yates’ case, her defense attorney used the insanity plea, which said in effect that she was not guilty of the crime because she was insane at the time of her actions. The Texas district attorney sought the death penalty against Yates (Yardley, 2001, August 9) . Because the disease is so little understood, even by many medical experts, public opinion was sharply divided into support and opposition camps—both for and against the legitimacy of the insanity defense for Yates and whether she deserved the death penalty if convicted. Although the medical field has studied PPD in increasing depth in more recent years and the legal profession has grappled with how to best deal with women suffering from PPD who kill their children, little if any research appears to exist to show how this


5 complicated health issue is being communicated to the general public. But, as one commentator pointed out, the news coverage across North America in the aftermath of the Yates event and trial has introduced new questions about the legal standard for mental illness, whether knowledge of right from wrong should be a consideration, and whether postpartum depression is properly recognized and taken seriously (Leggatt, 2002). The significance of this study, then, may be simply to look at what this news coverage is showing us; and to start discussion in the communications-research community on a topic that too often has been ignored or deemed a woman’s health issue that doesn’t have much broad impact. Postpartum depression is showing itself to be an issue that may become even more widespread, with a broader impact across many more individuals and groups than previously imagined, when some of the high risk factors for developing PPD and current American family demographic trends are considered. Risk factors for PPD include single marital status, lack of a strong family unit, and little or no social support network (The American College of Obstetricians and Gynecologists [ACOG], 2002) . Further, in the United States single motherhood is becoming more common (Baker, 1999) and accepted (Brinig & Buckley, 1999) at the same time that strong family units appear to be decreasing due to recent changes in composition, economic stability, and diversity of American families (Teachman, Tedrow, & Crowder, 2000) . The case of Andrea Yates affords an opportunity to obtain a clearer view of how the media frame PPD. It marks a key point in time when PPD was brought into the national limelight and raised awareness about this topic; it also offers a comparison of how PPD was framed before, during, and after this event and trial.


CHAPTER 2 LITERATURE REVIEW The Andrea Yates Story Andrea Yates, a homemaker, and her husband, Russell (Rusty), a NASA computer engineer at Johnson Space Center in Houston, seemed to be an ideal couple. Yates1 was valedictorian of her high school class and a competitive swimmer (Thomas, 2001, July 2) . Rusty Yates, a popular football and tennis letterman in high school, graduated summa cum laude from Auburn University in Alabama with a math degree and landed a job at the Johnson Space Center after internships there. The couple was strongly religious, particularly the husband, and planned to have a big family. At the time of the drownings, they had five children. The first four were boys, ranging in age from seven to two: the youngest child was a 6-month-old girl. The couple decided Yates would give up her job as a nurse to raise the children and home-school them (Thomas, 2001, July 2) . Although Rusty Yates has stated that his wife first suffered PPD after the birth of their fourth child, medical records show that she first mentioned having hallucinatory visions after the birth of her first child. Yates’ family has said a history of depression exists in four of her five siblings and some friends have claimed that Yates had some earlier problems with depression in high school. Yates seemed fine after the birth of her fourth child but attempted suicide shortly thereafter. She was hospitalized and put on 1 All references to “Yates” refer to Andrea Yates. 6


7 anti-depressant medication, but later was discharged when she improved. Yates was taken on and off antidepressants several times after that, and received therapy sporadically. After having their fifth child in November 2000, Yates’ PPD resumed, which was worsened by the death of her father in March 2001, and she apparently descended into PPP and a catatonic state (which is characterized by a marked lack of movement, activity, or expression). She attempted suicide a second time and was hospitalized and discharged twice. Yates’ final discharge was May 4, 2001. Rusty Yates told the press that his wife was taking the drug Haldol at the time of the children’s deaths, which is commonly prescribed for psychosis (Jones, 2001, June 22) , in addition to several antidepressants. On the morning of June 20, 2001, Andrea Yates called 911 and requested that police officers be sent to her house. When they arrived, the 37-year-old mother confessed that she had drowned her four youngest children one by one. Yates told police that she chased down her oldest son after he came in while she was drowning her daughter, and after a struggle, drowned him too. Immediately after summoning the police, Yates called her husband at work and told him that he needed to come home—something had happened to all of the children (Glenn et al., 2001). The police charged her that night with multiple counts of murder. Yates was found competent to stand trial, despite continuing to be in a catatonic state. She stated to examining psychiatrists that she had seen visions of a knife and was possessed by “Satan.” She was put back on anti-psychotic medication while in prison. One of these psychiatrists, who testified for the defense, diagnosed Yates with schizophrenia after interviews with her, a battery of neurological and psychological tests,


8 and a close study of her mental history. He noted that this was a different diagnosis than her previous ones of postpartum depression with psychosis or major depression with psychotic features. However, he also stated that schizophrenia can predispose someone to PPD (Christian, 2002, February 26). Due to the extensive media coverage surrounding these events, the judge almost immediately imposed a gag order on all participants in the trial until it was over. This gag order was upheld in spite of the Houston Chronicle’s efforts to fight it on a First Amendment basis. Yates was indicted on two charges of capital murder: one charged her with killing more than one person (Noah, age 7, and John, age 5), while the second charged her with killing a child under age 6 (the baby, Mary). Legal experts speculated that one reason Yates was not charged for the murder of all the children might have been a legal maneuver; if she was acquitted, the prosecution could seek to convict her at a later time for the other two deaths (Teachey, 2001, July 31) . The prosecution announced it would seek the death penalty while the defense countered by entering a plea of not guilty by reason of insanity. The trial began on January 7th, with jury selection taking almost 4 weeks to complete. Testimony began February 18th, with the trial itself also lasting nearly 4 weeks. Rusty Yates, his mother, and Andrea Yates’ mother all testified in Yates’ defense. On March 12th, the jury found Andrea Yates guilty of both charges after 3 hours of deliberation. After arguments were heard for the final sentencing phase of the trial, in which the prosecution offered no witnesses or arguments while the defense seated witnesses such as Yates’ sobbing mother (who begged for her daughter’s life after


9 reminding the jury that she had lost seven family members in one year), it took the jury a mere 40 minutes to reject the death penalty and sentence her to life imprisonment, with no possibility of parole until after 40 years had been served. Other Postpartum-Related Maternal Filicide Cases Although rare, other cases of maternal filicide2 have occurred in the United States. The most notorious in recent years was the 1994 case of Susan Smith, who strapped her two children into her car and rolled it into a lake and drowned them. A South Carolina jury eventually found her not guilty by reason of insanity. Two professors, Cheryl Meyer and Michelle Oberman, studied and documented cases of hundreds of mothers who killed their children during the 1990s in their book “Mothers Who Kill Their Children: Understanding the Acts of Moms from Susan Smith to the Prom Mom.” Some of the cases noted in this book include Marilyn Lemak from a Chicago suburb, who smothered her three children in 1999; Melissa Drexler, the teenaged New Jersey “Prom Mom” who gave birth in a restroom during her high school prom in 1997, threw her baby in a trash bin and returned to the dance; and Jennie Bain Ducker, a young Tennessee mother who left her two toddler-aged children strapped in their car seats overnight in 1995—they subsequently died when the temperature inside the car reached 120 degrees the next day. In Harris County, where Andrea Yates lived, several previous cases involved mothers who killed their children. The precedent for a harsh sentence such as the death penalty was not set during these cases, however. In fact, one woman who drowned her children in a bayou received probation in a plea agreement (Tolson, 2001, September 10) . 2 Filicide is defined most commonly as the killing by a parent of a daughter or son.


10 Mothers suffering from severe PPD and PPP often present a risk to themselves as well as their children, and many commit suicide due to their fear of being a bad mother and harming their children. During the summer of 2001 alone, four new mothers in the Chicago area committed suicide in a five-week period (Rotzoll, 2001, July 22) . Shortly before that (in April 2001) a woman from the St. Petersburg, Florida area, Janet Gifford-Meyers, committed suicide by drug overdose less than a month after giving birth (Lush & Fields, 2001, April 18) . In some cases, the mothers kill their children and then themselves, not always succeeding in the latter effort. Two immigrant women living in different states, one from Salvador and another of Hmong descent3, killed their children and then attempted suicide. The first was found legally insane and acquitted, while the second was sentenced to 50 years in jail (Tolson, 2001, September 10) . Eerily, a case occurred in 1965 that mirrored Andrea Yates’ almost exactly. A 38-year-old Hawaii mother named Maggie Young drowned her five children, laid the naked bodies on a twin bed, and then called the authorities. She had been suicidal and hospitalized for postpartum depression and psychosis earlier that year. However, in her case, she was not found fit to stand trial and was institutionalized. Six months later she hanged herself after finally starting to improve and respond to medication and realizing the full import of what she had done. Her husband, James Young, although worried about her, did not think she would hurt the children—much as Rusty Yates had thought of his wife. A retired Air Force officer, Young has offered sympathy for Andrea Yates and criticized her prosecution 3 This ethnicity originated in northeast China.


11 publicly, arguing instead for her institutionalization. Rusty Yates contacted Young for advice after he found out about the Hawaii case, and the two men corresponded by email for a time (Feldman, 2002, February 4 ; Tolson, 2001, July 1) . FBI documentation has found that approximately 1,000 children were reported killed by their mothers in the 1990s. This figure may be lower than the actual one, according to Meyer and Oberman (2001), due to instances such as when the body of a newborn is secretly disposed of in a city dump and never found or the mothers are never identified. The two authors concluded that the incidence of mothers killing their children is on the upswing, perhaps in part due to the increase of single motherhood and the lack of extended family support in raising children. Many new mothers today not only are more likely to be isolated compared to earlier generations when their mothers, sisters and other family members would often stay with them for several months after childbirth, but also have societal expectations placed on them to be a “Super Mom”: to work during pregnancy, shortly after delivery, and during child-raising, as noted by a Chicago-area obstetrician and gynecologist (Rotzoll, 2001, July 22) . This sense of isolation faced by an increasing number of new mothers in the United States may escalate the chances of PPD developing. Research by a PPD expert found that people in Latin American cultures, where the extended family-support system is very strong following the birth of a baby, suffer far fewer cases of PPD (Sammons, 2001, October 21) . The Postpartum Depression Issue It has been argued that PPD is a major public health problem, with 10 to 15 percent of recent mothers affected; up to 28 percent of these mothers live in poverty. Yet approximately 50 percent of women with PPD are untreated. It is estimated that about a quarter of untreated mothers with PPD never completely recover. The chronicity of the


12 problem, rather than the severity of it, has more long-term effects on infants and young children. The longer PPD continues unchecked, the more difficult it becomes to treat. And one PPD expert has noted that the most common consequences of untreated PPD are poor bonding with the baby and marital problems, which can end in divorce (Condor & Brotman, 2001, June 27) . So how do the media impact the issue of PPD and what are the implications of this influence? The repercussions begin with how PPD is defined by various medical experts, as well as society itself, which in turn determines what is viewed as the best form of treatment. These may be reflected by the media or set forth as frames within which to understand this topic completely. A study by Martinez et al. (2000) found three competing models of postpartum affective disturbances that are currently in vogue and which may influence media frames: the medical model, the stress and coping model, and the feminist model. According to this study, the medical model posits biological variables such as hormones or neurotransmitters as the cause of postpartum mood disturbances and recommends psychotropic medications or electro-convulsive therapy to manage depression. This model is most prevalent in the professional literature and most popular with physicians. Experts working from this model focus more on the impact of depression on the mother-child bond, infant development and the emotional state of the infant’s father than on the mother herself (Johnston-Robledo, 2000, as cited in Martinez et al., 2000 ). The stress and coping model, which is most popular with health psychologists and other social scientists, suggests that these disorders are due to stressors that occur after


13 the birth of a baby, such as fussy babies and role adjustments. Social support is the commonly recommended intervention. Some social scientists suggest that PPD is a culture-bound syndrome that is not found in societies that have a structured, supportive postpartum adjustment period for new mothers. The feminist model takes a contextual and a political approach to PPD. Experts working from this perspective criticize the categorization of the symptoms and the assumption that postpartum mood changes are necessarily abnormal. A study using the feminist model found four common stressors for women who had recently given birth: physical adjustment, initial insecurities, support networks, and loss of former identity. This perspective shows that women may underestimate the physical, psychological, and social adjustments that new mothers must make, and may judge themselves as inadequate or even crazy. They then may lose trust in their ability to parent and instead seek advice from physicians, psychologists, social workers, family, friends, or even magazines and self-help books (Martinez et al., 2000) . Not only are the women with this illness affected, but the medical, legal and public policy areas are impacted as well. How this ripple of impact spreads is determined by the medical establishment’s definition, treatment and research of PPD; by attorney use of defenses such as the insanity plea and judicial case rulings on mothers who commit infanticide; and by the visibility of special interest and support groups and public health policy and legislation. Stakeholders most personally involved are women who have children and their families. Indeed, up to 85 percent of women suffer the mildest form of PPD, typically called “baby blues,” after childbirth, and 10 percent slide into full-fledged postpartum


14 depression. Other stakeholders include physicians (particularly obstetrician-gynecologists and psychiatrists), criminal lawyers who defend or prosecute women who have harmed their children and public policymakers. Special interest groups are also stakeholders. The National Organization for Women (NOW) is one political lobbying group that raised money for Andrea Yates’ defense fund. NOW was joined by the American Civil Liberties Union (ACLU), other feminist and health groups, and several anti-death penalty organizations. At the root of the insanity defense as it applies to mothers who have harmed or killed their children is the argument about whether PPD stems from biological or environmental causes. Huang and Mathers (2000) concluded from their study comparing postnatal women in the United Kingdom (UK) and Taiwan that the prevalence of PPD is similar in both cultures, despite major differences in post-childbirth rituals and postpartum healthcare systems, thus lending support to the hypothesis that PPD may have at least some important biological determinants as well as cultural and social ones. The Medical Angle The 1994 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) recognizes PPD as a separate category from depression manifesting at other times, although some researchers debate the existence of convincing evidence for PPD to be a separate clinical entity (Martinez et al., 2000). Postpartum depression describes the range of physical, emotional, and behavioral changes that many women experience following the delivery of their babies (The National Women’s Health Information Center, 2002) . There is often confusion about postpartum mood disorders, which can be classified by three conditions (ACOG, 2002).


15 The range of postpartum conditions range from the milder baby blues to the more serious postpartum depression, to postpartum psychosis, the most severe form of this illness. Postpartum blues is the most common aspect of this illness, which ACOG (2002) estimates affects 70 to 85 percent of women suffer within hours or days after childbirth. Baby blues are thought to be caused by the sudden drop of progesterone and estrogen within the 48 hours after childbirth. It is characterized by sudden mood swings, with intense feelings of loneliness, sadness, fear, anger, anxiety or low self-esteem. Symptoms may include crying for no apparent reason; having trouble sleeping, eating, and making choices; questioning of ability to care for the baby; impatience; irritability; increased sensitivity; and heightened feelings of vulnerability. This condition is considered normal after childbirth and often disappears as suddenly as it arises, usually without medical treatment and with the help of rest, nutrition, mild exercise and a social support system. Postpartum depression is present after 10 percent of pregnancies, the statistic most commonly cited in medical research. It is more intense and must be present for more than two weeks to distinguish it from the baby blues. The exact cause of the illness is unknown. Research suggests that PPD may be triggered by the hormonal shifts that occur after delivery and are greatly exacerbated by the stress of a major life change (ACOG, 1999, 2002) . However, a complex mixture of biological, emotional, behavioral, and environmental factors likely combine to produce this condition. Suspected biological triggers include the rapid changes in estrogen and progesterone levels and thyroid deficiency. Other factors can include broken sleep patterns and insufficient rest, changes


16 in work and home routines, and feelings of loss (of identity, freedom, control, a slim figure or physical attractiveness). Symptoms can manifest any time in the first year after childbirth, and can occur after any birth, but usually begins with two to three weeks after giving birth. These symptoms include constant fatigue, lack of joy in life, a sense of emotional numbness, withdrawal from family and friends, severe insomnia, loss of sexual interest or responsiveness and a strong sense of failure and inadequacy (Mayo Clinic Staff, 2002). ACOG (2002) also notes irritability, intense anxiety, lack of appetite, crying spells, irrational behavior, and highly impaired concentration and decision-making as symptoms. Basically, this condition disrupts a new mother’s ability to function, a key sign that medical treatment is needed. Postpartum depression can last for months, up to a year and a half or longer, if left untreated. Postpartum depression is more likely to occur in women who lack the support from partners, family members, doctors, and friends, and who have had a previous PPD or depression unrelated to pregnancy. Other associated risk factors can include severe pre-menstrual syndrome, bipolar disorder, or recent stress, such as the loss of a loved one, family illness, or relocation to a new home. Feelings of isolation are very common among women with PPD. The risk of having a postpartum depressive episode increases with successive pregnancies for women with bipolar disorder (previously known as manic depression) (Freeman, Keck, & McElroy, 2001) . The risk of recurrence in women with a history of PPD is about one in three to one in four. Treatment typically consists of antidepressant medication, psychotherapy, support groups, and/or hormone therapy (ACOG, 2002).


17 Postpartum psychosis is relatively rare. Statistics concerning the incidence of this manifestation vary according to medical source, but most agree that it occurs in one out of 1,000 new mothers. Onset is severe and quick, usually within the first 3 months after delivery. Women who suffer from PPP may completely lose touch with reality, often experiencing hallucinations and delusions. Other symptoms may include insomnia, agitation, paranoia, hysteria, and bizarre feelings and behavior. A medical emergency response is appropriate for PPP, with medication and usually hospitalization required (ACOG, 2002) . Screening tools have been developed in recent years to try to identify pregnant women most at risk for suffering PPD. These screenings are a simple yet effective way to identify PPD for prevention and treatment purposes. The importance in adapting these tools for consistent screening of pregnant women has been highlighted due to the latest research on PPD, which shows that these women show clear warning signs during pregnancy that are usually ignored by doctors, fathers-to-be, and family members. These warning signs typically include symptoms of anxiety or depression demonstrated by the woman during pregnancy, such as crying frequently, having trouble sleeping, and not being able to concentrate (Sammons, 2001, October 21) . One of these tools is the Edinburgh Postnatal Depression Scale, which was developed in 1987 and is widely used in the UK and Europe. It is a 10-item self-report measure whose validity and reliability have been supported through many studies, according to Huang and Mathers (2000) . A newer and more extensive screener is the Postpartum Depression Screening Scale (PDSS), which was developed in the United States and released in September 2001


18 for use by medical practitioners. This is a 35-item self-report instrument that can be administered within 10 minutes and identifies women are at a high risk for PPD. It is written at a third-grade reading level and yields an overall severity score of depressive symptoms such as: normal adjustment, significant symptoms of PPD, or positive screen for major PPD (Beck & Gable, 2003). In addition, scores for the following seven symptom areas are calculated: Sleeping/Eating Disturbances Anxiety/Insecurity Emotional Lability Mental Confusion Loss of Self Guilt/Shame Suicidal Thoughts The Legal Angle: The Insanity Defense The insanity defense has been controversial ever since it was created 150 years ago in Victorian England. The standard that was developed boiled down to a basic question: Did the defendant know his conduct was wrong at the time he committed the crime? Depending on the answer to this question, a defendant could be found criminally responsible even if he was in extremely ill mental health (Bard, 2002, March 13). Legal experts with experience in this area of law usually agree that it is difficult for American defendants to win this particular kind of case. Historically, juries have distrusted insanity pleas, and only a small fraction of those who use this defense are acquitted (Parker, 2002, March 15) . Using PPD as the basis for the insanity plea is a fairly novel criminal defense, joining the use of post-traumatic stress disorder and battered woman’s syndrome in recent years.


19 Laws in Texas regarding the insanity defense are among the strictest in the nation, requiring defendants to prove they did not know what they did was wrong at the time of the crime and that the crime was intentional beyond a reasonable doubt (Wiener, 2001, June 22) . Some other states merely require that the defendant felt an overwhelming compulsion to carry out the crime (Carson, 2001, June 26 ; Williams, 2002, February 27) . In the 1970s, many states used a more lenient form of the insanity plea in which the defendant could not be found guilty if he had been “incapable of conforming his conduct” and controlling his behavior within the limits of the law, even if he knew he knew his conduct was wrong. However, after John Hinckley was acquitted by reason of insanity in 1982 after attempting to assassinate President Ronald Reagan, citizens and lawmakers across the nation were appalled, and many states, including Texas, rewrote the insanity law or eliminated it altogether (Bard, 2002, March 13 ; Parker, 2002, March 15) . Regardless of whether the insanity standard is broad or narrow, though, numerous studies show that jurors make the same kinds of decisions. A psychiatric expert interviewed for a newspaper article stated that jurors take into account the nature of the crime, and the more heinous it is, the less likely they will vote for an insanity verdict (Parker, 2002, March 15) . Insanity defenses based on postpartum depression are rarely tried and not often successful. Juries tend not to like the idea that someone who was institutionalized rather than jailed due to a successful argument of the insanity plea may be freed one day if she recovers. Juries also find it hard to believe a sane woman standing before them who has been treated and whose hormones have returned to normal or who is on anti-depressant and/or anti-psychotic medication may have been completely


20 psychotic only a few months before. In addition, jurors tend to be unsympathetic to anyone accused of harming a child (Wiener, 2001, June 22) . Dobson and Sales (2000) noted that over the years, women who murder their children have been the subject of intensive media and public scrutiny. Reactions have varied from horror at the cruelty of the act to sympathy for the perpetrator, based on the belief that the mother must have been severely mentally disordered or at least suffering from a diminished mental capacity at the time of the offense. As a result, the English and American legal systems have adopted very different legal responses to this crime. In fact, America differs from many other countries in its laws regarding infanticide. Approximately 30 countries, including Great Britain, Canada, Italy and Australia, recognize postpartum depression as a legal defense. The British Infanticide Act of 1922 (updated in 1938) permits prosecution for manslaughter, but not murder, for any woman in England who kills her child in the first year of the baby’s life. Typically, such a woman will be given psychiatric treatment, then would plead guilty to manslaughter and be placed in a mental hospital (Wiener, 2001, June 22) . Underlying the varying legal positions countries take are assumptions about the effect of childbirth on mental status and the relation of mental status to the legal criteria necessary to meet a legal defense (e.g., insanity) or necessary to justify charging the offender with a lesser crime. Framing Theory The framing concept creates a way to analyze critically how the media present an issue or event, in the process defining and directing discussion about them. Framing intersects agenda-setting when the media go beyond telling us what to think about—the selection of objects, issues, events, or personalities for attention—and the focus becomes how to think about it—the attributes of the object on which to focus attention (McCombs


21 & Shaw, 1993) . What becomes most important is the definition determined by the media based on their interpretation of the situation (Lane, 1998). “Framing theorists suggest that the way an issue is presented—the frame—especially through the media, can affect public perceptions of the issue” (Bridges & Nelson, 2000, p.100) . Andsager and Smiley (1998) noted that public opinion could be shaped through the news media’s coverage of controversial events. The ability to frame an issue is especially important in controversy surrounding potentially scientific or medical matters, which are inherently complex. Framing research may look for verbal and visual cues that direct the audience’s attention in one direction while serving to obscure another (Zoch, 2001). This use of framing to categorize a subject is especially pertinent to the discussion of PPD because it currently is such a contentious and complicated issue, with many different parties competing to portray it in certain ways so as to influence the public and policymakers. Framing theory hypothesizes that media select some aspects of a perceived reality and make them more salient in a communicating text in such as way as to promote a particular problem definition, moral evaluation and/or treatment recommendation (Entman, 1993) . Framing looks at relationships among elements in a media story, looking at not only the choice of words, phrases and quotes included but also what aspects are not included (Maher, 2001). Of course, as noted by Entman, these key words are not of themselves frames. Rather, the words are indicative of perspectives, or points of view, by which issues and events can be discussed and interpreted. As Lane (1998) pointed out, a qualitative analysis steps back from the news text and looks not only at which sources are quoted or paraphrased and how many times, but also at why those sources were chosen or emphasized, why others were excluded or trivialized, and what


22 this means for the direction of the debate. The sources cited and those ignored by the media can have a significant effect on how an issue is framed. Journalists use frames to develop their stories within the infrastructure and requirements of journalism (Gitlin, 1980). These media frames involve the context, content, topic, coverage and package of news events. McCombs, Einsiedel, and Weaver (1991) found that “central to the genre of journalism is the story,” using many of the same plots and themes used in literature (McCartney, 1987) . The most common of these is the notion of good and evil, which are demonstrated through plots that actors live out in dramatic, narrative terms. In a similar way, each news story is the enactment of stories (plots and themes) by characters in scenes (Palenchar, 2001). This aspect of framing is particularly relevant to the Andrea Yates event, which in many ways was rendered as a novel, with the development of characters and themes to draw together the disparate pieces of the story and the underlying role of good versus evil in shaping circumstances. The ways in which Yates’ story are presented by the news media indicates whether the issue of PPD is seen as a significant one. Blumer (1946) and Park (1972/1904) argue that while the term “issue” often is used loosely to describe any topic that captures public attention, a more appropriate way to define an issue is as a topic for which policy decisions must be made. Journalistic framing of issues impacts public understanding and consequently policy formation (Gans, 1983). In the realm of health policy formation, media framing may have a large impact on public health (Walsh-Childers, 1994) . Like Andsager and Smiley’s (1998) comments in their research on how news coverage shaped the silicone implant controversy, the PPD issue similarly is unique in being one of only a few health risk controversies that is entirely associated with women. And also like the


23 silicone implant issue, it juxtaposes the interest of powerful groups—in this case, the public, the medical profession, the legal profession and special interest groups. The media tend to reinforce conventional definitions of health problems and hence they determine the legitimacy of various solutions. News stories about medicine may “increase or diminish the willingness of individuals to present themselves for care, and raise expectations, and dash hopes, or may provoke alarm” (Winsten, 1985) . Media framing is important to the extent that it makes isolated incidents related in the public issues (Andsager & Smiley, 1998) . This is notably true in this case, with the isolated incident of Andrea Yates drowning her children related to the public issue of PPD. Media Framing by Stakeholders Through these factors described, media portrayals of issues are ascertained not only by the journalists’ and editors’ framing decisions, but also by stakeholders’ attempts to frame issues. Lyons, Schieb and Richardson (1995) offer a useful interpretation of stakeholders, using the term to refer to individuals and groups in the policymaking process who stand to win or lose as a result of a policy decision. Miller and Riechart (2001) describe framing more fully as an ongoing process by which ideological interpretive mechanisms are derived from competing stakeholder positions. These selectively representative frames are manifest in the choice and range of terms that provide the context in which issues are interpreted and discussed. More specifically, “frames are the principles of selection, emphasis, and presentation composed of tacit little theories about what exists, what happens, and what matters” (Gitlin, 1980) . The process of framing becomes more apparent when stakeholders compete for support. Controversies persist precisely because stakeholders martial different facts and different interpretations of the facts (Miller & Riechart, 1980) . The dominant


24 stakeholders have framed the issue of PPD in medical and legal terms. When scientists are identified as one of the policy actors in a debate, they are perceived as “the source of authoritative evidence and definitive solutions (Nelkin, 1989, as cited in Andsager & Smiley, 1998) . Medical frames, especially by physicians, have focused on the biological and physiological causes of PPD. Many physicians also have noted environmental and cultural factors that play into the severity of PPD’s manifestation. Defense lawyers have focused on the difficulty of proving the insanity defense, although a few have noted that juries have been sympathetic in the past to certain categories of people who plead insanity, of which mothers who commit infanticide is one. Prosecutors have framed the legal angle to show that a full range of punishment should be allowed in a capital murder case such as this. Newspapers also have made much of the fact that Harris County, where Yates’ case will take place, has the highest death penalty success rate in the United States (Delfiner, 2002, March 14 ; McRoberts, 2002, February 8 ; Tolson, 2001, September 10 ; Yardley, 2001, July 2 ; Yardley, 2001, August 9) . However, legal experts also have framed the prosecution’s seeking of the death penalty in this case as a bit unusual, if not difficult, because prosecutors would have to prove that Andrea Yates represents a future threat to society. Special interest groups such as NOW have put a feminist frame on the Andrea Yates case, while anti-death penalty groups joined forces with NOW to form a coalition to fund Yates’ defense. They argued that a woman suffering from mental illness should not be punished by the criminal justice system, but instead needs treatment at a psychiatric institution.


25 Research Questions This study seeks to answer the following research questions: How do newspapers and stakeholders define PPD? How have the media framed PPD in the recent controversy and coverage stemming from Andrea Yates drowning her children? How does framing during and after the Andrea Yates event compare to previous media framing of PPD? Did national newspaper coverage differ from local coverage of the Andrea Yates case?


CHAPTER 3 METHODOLOGY This study examined media framing of PPD before, during and after the Andrea Yates focusing event. This allowed comparison of coverage and framing of PPD before and after the Yates’ children’s drownings as well as the subsequent trial, to see what effects, if any, there were after PPD was brought onto the national stage in this unprecedented way. Newspapers Both national (elite) and local (non-elite) daily newspapers were chosen as the most appropriate to examine for this study because of the national coverage of the Yates event and the many stakeholders involved. These stakeholders range from women suffering from PPD to medical and legal practitioners to government policy-makers and special interest groups. The major national newspapers often set the agenda for other newspapers. Looking at the local newspapers offered a chance to see what differences arose for their coverage of PPD and Andrea Yates compared to the national newspapers and to reveal any patterns. The following elite national newspapers were chosen for analysis: Chicago Tribune The New York Times USA Today 26


27 The following local newspapers were chosen for analysis: Chicago Sun-Times The Houston Chronicle The New York Post St. Petersburg Times The Houston Chronicle was chosen because it is the major daily newspaper in Yates’ hometown. Examining this newspaper offered a chance to compare local newspaper coverage and framing to national coverage and framing of the Andrea Yates event and PPD. The Chicago and Tampa Bay areas had had several cases of infanticide or suicide linked to PPD in the year before Yates did; thus newspapers from these regions were selected to add depth and breadth to PPD coverage during that time. Two Chicago-area newspapers were chosen to determine if local coverage and framing differed within the same local area. For this reason as well, two New York newspapers were selected. Because The New York Post is considered a tabloid, this offered a chance to determine if differences in news reporting styles affected framing of PPD. The New York Times and USA Today represent two of the most widely read major national newspapers in the United States. Therefore, they are most likely to indicate the dominant frames used to portray this issue throughout the country. Time Frame The time frame chosen was 2 years, beginning July 21, 2000 to July 21, 2002. This time frame was chosen to better compare if and how PPD was covered by media before Yates killed her children, to coverage afterward and during the trial, as well as for a few months afterward, when increased national awareness was paid to this particular mental illness.


28 Search Terms The LexisNexis Academic database, with its access to newspapers and wire services all over the world, was searched to locate articles for analysis. The articles for all of the newspapers except the Chicago Tribune and USA Today were retrieved from the LexisNexis Academic Search Page. Chicago Tribune articles were not available through LexisNexis and were gathered via the newspaper’s on-line archive of previous news stories. USA Today was retrieved through the online database Factiva/Dow Jones and Reuters via the University of Florida libraries. The on-line archives of the newspapers also were searched in order to retrieve any articles that were not available via LexisNexis. To create the search terms on LexisNexis, the following method was used: First, for the Guided News Search, the news category of U.S. News was selected. Then according to the region of the country in which the newspaper was located, the Midwest, Northeast, Southeast and Western Regional Sources were selected, and the appropriate newspaper chosen from the source list. Next, the full texts of the articles were searched using the search terms “Andrea Yates,” “postpartum depression” and the Boolean operator “OR.” Initial searches used both “OR” and “AND” as Boolean operators, but it was found that this did not bring up any additional articles than those retrieved with just “OR.” “OR” was used instead of “AND” to bring up as many articles as possible, not only about Andrea Yates and references to PPD in the context of her case, but for any other articles that discussed PPD in general or in relation to similar cases. The date range specified for article retrieval was June 21, 2000, to June 21, 2002.


29 For the Chicago Tribune on-line newspaper archives, which required payment for articles more than seven days old, the advanced search page was used. The same search terms, Boolean operator and date range as described previously were used, and all sections of the newspaper were searched. Due to the cost of viewing the large number of newspaper articles that were retrieved, as many articles as possible were screened and deleted if found not to be relevant to the purpose of this research by viewing the free abstract provided. However, the brevity of the abstracts only allowed a few irrelevant articles to be discarded in this way. For the USA Today search on Factiva, the same search terms, Boolean operator and date range as described previously also were used, and all sections of the newspaper were searched. One article from The New York Times was copied from a paper version of the newspaper obtained from the University of Florida library and one actual USA Today article was from the newsprint version of the paper. Article Criteria for Content Analysis Articles chosen for framing analysis included news, editorials, opinion pieces, and features. This represented a broader and more in-depth range of coverage on PPD and related issues, not only by media gatekeepers and hard news reporters, but also by columnists and guest writers who represent various voices of public opinion. This in turn provided a better selection of articles from which to gather frames and compare them. These articles then were examined to determine if they focused on PPD or the Andrea Yates story, by checking the headline, lead, or overall story topic. Articles less than 100 words in length and News in Brief or other news summary updates were not included in the study because they were not considered long enough to allow for development of a cohesive frame and often just gave basic facts and brief


30 information without being in a typical article format. Similarly, articles that only briefly mentioned PPD but did not feature that topic or aspects of the Andrea Yates event also were omitted. However, articles that did not mention Andrea Yates but covered other women’s cases who also suffered PPD or PPP and gained notoriety for killing themselves and/or their children in the same time period were analyzed. Additionally, letters to the editor were not included because newspaper reporters or editors do not write them; thus the words chosen and the opinion voiced do not necessarily represent the newspapers’ frames. Information then was extracted from these articles and noted on a two-page standardized coding sheet (see Appendix A). This sheet included basic information such as the newspaper’s name, date of article, reporter’s name, newspaper section, page number, length of article, location of the reporter and of the geographic level of the item (whether it was of local or national significance). The headline, lead, and main topic of the story was noted, as well as whether or not PPD was defined, and if so, how. Sources for direct quotes were noted, as was the order in which the sources were presented, and who was given the most coverage or quote space. If a source had a particular point of view on the PPD issue, it was noted, and if an article focused on a certain issue, it was noted (such as legal, medical, or gender-related issues). Framing techniques (frequently occurring words, key words and catchphrases, loaded words or phrases, quotation marks, figures of speech, visual images, or themes) were marked directly on the story. Finally, at least one named frame was noted as the overall frame of the story, or for a substantial proportion of it. Many articles had two or more frames used throughout the articles.


31 To establish validity, a second coder also coded 20 percent of the total articles for each newspaper. A skip interval method was used to select these articles, starting with the first article for each newspaper. The second coder had studied qualitative research and the framing theory through graduate-level mass communication classes, so no additional training was necessary. Each coder analyzed the data, and once the coding was finished, the coders compared their results. The coders discussed the frames each found and in the case of any discrepancies, the coders explained how they had arrived at their conclusions. Most of the dominant frames were readily agreed on. In the case of one frame, both coders had coded a wide variety of terms and phrases that loosely seemed to tie together but did not have one common theme. They came to an agreement on this frame by creating subcategories that more specifically grouped similar items together.


CHAPTER 4 RESULTS Using the newspapers specified and the terms defined in Chapter 3, a total of 256 articles were examined: 49 from the Chicago Sun-Times, 59 from the Chicago Tribune, 54 from The Houston Chronicle, 35 from The New York Post, 29 from The New York Times, 12 from the St. Petersburg Times, and 18 from USA Today. These articles were analyzed for frequently occurring words, catchphrases, themes and stakeholders’ or reporters’ frames. The initial bulk of the PPD news coverage occurred from April to September 2001, starting with a St. Petersburg woman suffering from PPD who killed herself; peaking in June when a Chicago-area woman committed suicide and Yates confessed to drowning her children; and maintaining high coverage through July and August 2001. After September 11, news coverage on this issue dropped dramatically due to the terrorist attacks on the World Trade Center and Pentagon. Coverage spiked again at the beginning of Yates’ trial, which began January 7, 2002, and continued through its end in mid-March. Across the newspapers, the main topic of most of these articles was Andrea Yates. Other topics that occurred less frequently were articles about local PPD cases and PPD itself. The majority of the newspapers’ articles were published in the “News” or front-page section (i.e., the “A” section) for the newspapers for which information was 32


33 available about the section an article was published in1. Frequently, these articles were on the front page or within the first several pages of the “A” section. The only exception to this pattern was the St. Petersburg Times, for which most of the articles were published in the “City & State” section. The Houston Chronicle also published a substantial number of articles in its “Metfront” section, but this was also part of the newspaper’s “A” section. The other sections in which these articles often were found were “Editorial or Commentary,” “Health & Fitness” (mainly for The New York Times), and “Woman News” (mainly for the Chicago Tribune). For most of the newspapers, the geographic level of the item or event being reported was national, mainly originating in Houston2. In the case of The Houston Chronicle, almost all of the articles were considered to be at the local level since the Andrea Yates event occurred in the newspaper’s hometown. The Chicago newspaper articles were split, with approximately half of the articles at the national level (mostly about Andrea Yates) and the other half at the local level, due to the several local PPD-related cases that gained public attention during this time. Most of the St. Petersburg Times articles were at the local level as well, due to a local PPD case. The articles varied in length from just over 100 words for brief hard news items to well over 2,000 words for feature stories. However, across all the newspapers, the 1 Neither the Chicago Tribune nor The New York Post gave this information. The New York Post only listed the page number of the article, but did not indicate the section. Most of the Chicago Tribune articles were retrieved from the newspaper’s own archives, which did not include section information. 2 72 percent of the newspaper articles except The Houston Chronicle’s were at the national level. The Houston Chronicle was not included because it skewed the percentage of national versus local articles significantly. However, even including The Houston Chronicle articles, the majority of the articles were still at the national level (59 percent).


34 average word length of the stories ranged between 400 and 800 words, with most articles using approximately 700 to 750 words. See Appendix B for more detailed information about word count, section location, and geographic level of the articles. Research Question 1: How Do Newspapers and Stakeholders Define PPD? This section first illustrates the results of how many actual articles from each newspaper defined PPD specifically. Then the definitions used by each newspaper for their individual articles are categorized and discussed. Lastly, the results of how stakeholders defined PPD are looked at more closely. Table 4-1 below shows the total number of articles fitting the previously defined criteria that were coded for each newspaper. Also shown are the numbers of articles for each newspaper that explicitly define PPD within the context of the story. Table 4-1. Articles coded and articles defining PPD. Newspaper Total articles coded Articles defining PPD Chicago Sun-Times 49 6 Chicago Tribune 59 17 Houston Chronicle 54 4 New York Post 35 0 New York Times 29 0 St. Petersburg Times 12 4 USA Today 18 1 Total 256 32 The most significant finding was how little the news media discussed PPD specifically, even in reference to the events surrounding Andrea Yates. Of the 256 articles analyzed, only 32 defined PPD in any detail at all. This included articles that defined PPD minimally or partially. For example, a newspaper might focus on just one aspect of PPD, like postpartum psychosis, but not specify all three levels of PPD (the baby blues, postpartum depression, and postpartum psychosis) or give a full description of possible symptoms and behavior associated with PPD. Articles that only gave


35 statistics about how many women suffered the baby blues, PPD, or PPP, or simply noted the three levels of PPD without an explanation of each one were not considered to be defining PPD. The Chicago Tribune had 18 articles that defined PPD, according to these criteria, the most of any of these newspapers. However, this figure was atypical for almost all the other newspapers’ proportion of stories that defined PPD. The Chicago Sun-Times contained six articles defining PPD, the next highest amount. Of the 12 articles analyzed from the St. Petersburg Times, only four defined PPD. The Houston Chronicle also had four articles defining PPD. USA Today produced one article that described PPD. Neither The New York Post nor The New York Times yielded any articles that defined PPD, although the latter newspaper had one article that simply differentiated the three levels of PPD but did not define any of them in-depth. Interestingly, of the newspapers that defined PPD, almost all of these particular articles were published either before Andrea Yates drowned her children, or within the first week after she did so. The Chicago Tribune was the only newspaper to buck this trend, offering articles discussing PPD partially or in-depth through November 2001. Most of the Chicago Tribune’s articles focusing on PPD or defining it thoroughly within the context of a larger story were published from October 2000 to the end of June 2001. Eight of these articles actually occurred before the Yates event in June 2001. The unusually high number of articles delineating PPD is due to the fact that approximately 2 weeks before the Yates drownings, a Chicago woman with PPP, Melanie Stokes, was announced missing and found just before she jumped out of a 12-story hotel (final reports ruled it a suicide). These articles accounted for half of the 10 articles published in June,


36 while the other half were published subsequent to the Yates event. Three articles discussing PPD specifically ran in the Chicago Tribune earlier on, in the fall of 2000. The Chicago Sun-Times ran all but one of its articles defining PPD in June 2001, beginning with the announcement of Melanie Stokes’ disappearance, and ending after June 22nd. The first three of these articles focused on PPP in particular, mentioning in passing PPD as its less severe form. The last article was an editorial that ran on March 3, 2002, during Yates’ trial, merely defining PPD as a hormonal imbalance. The St. Petersburg Times published all of its articles with a definition of PPD before June 2001, with most of these appearing in April. At the time, a search was underway for a missing woman, Janet Gifford-Meyers, from that region (Pasco County) who had been suffering from PPD. She was found dead in a nearby forest preserve shortly after her disappearance initially was publicized3. The Houston Chronicle, the newspaper of Andrea Yates’ hometown, ran all of its articles discussing PPD by June 26, 2001. USA Today followed suit, running its one published article about PPD on June 22, 2001. To get a general picture of when newspapers ran the most articles explaining PPD in detail, see Table 4-2. 3 Only three articles were retrieved from the St. Petersburg Times that referred to the Andrea Yates case. The majority of the news about this case was covered in the paper’s The Nation In Brief section and updated on a regular basis. Since such brief news updates were not included for this study’s analysis, most of the St. Petersburg Times’ information relevant to Andrea’s case thus was excluded.


37 Table 4-2. Dates of articles defining PPD. Newspaper Article Dates Chicago Sun-Times 2001: June 9, 10, 12, 22 (2 articles) 2002: March 3 Chicago Tribune 2000: October 29 November 26 2001: June 10, 11, 12, 15 (2), 22, 23, 24, 27 (2) July 4, 19 August 29 October 21 November 19 Houston Chronicle 2001: June 21 (2), 22, 26 New York Post None New York Times None St. Petersburg Times 2001: April 16, 18, 22 May 4 USA Today 2001: June 22 In general, beyond the first week after the Yates event (or after the initial publicity surrounding the two other cases in Chicago and St. Petersburg), the media appeared to presume that the public understood what the reference to PPD meant. Most frequently, any reference to PPD in a newspaper article merely was to note it as Andrea Yates’ diagnosis. This was described most commonly with the phrases “suffering postpartum depression,” “spiraled down into postpartum depression,” or “postpartum depression with psychosis,” but was not defined further, especially once her trial got underway and the focus was on the latest update in her case. Several newspapers merely made a general reference to her diagnosis as a mental illness, especially in later articles that ran during her trial. The most significant finding across all of the newspapers was the variation in how PPD was defined and on what aspects were focused. Whereas one newspaper might attempt to reassure the public by emphasizing that PPD is the most common complication following childbirth and that it usually is managed easily, another might highlight the


38 complexities surrounding the condition, or portray PPD as an inherently uncontrollable condition which causes the women who suffer from it to behave in a unhinged manner. There also was inconsistency and oftentimes an expressed uncertainty in the described causes of PPD—not only across newspapers but sometimes within the articles for one newspaper. One newspaper (Chicago Sun-Times) chose to focus almost exclusively on the medical causes of PPD, placing the responsibility on the abrupt hormonal shift after childbirth, while others described the interplay of social and medical factors as the cause, and one newspaper (The Houston Chronicle) cast doubt on the role of hormones in causing PPD. This inconsistency ultimately may reflect the fact that much still is not understood about PPD. The Chicago Sun-Times In general, the Chicago Sun-Times focused on the medical causes of PPP (more so than PPD) in its definition, with no mention of other causes such as social, familial, or previous mental health status. The majority of the articles differentiated the levels of PPD and gave the most common statistics for the baby blues, PPD and PPP (i.e., one woman in 10 who gives birth suffers some form of PPD and one in a thousand develops PPP). The articles explained that PPD is a medical condition caused by hormonal fluctuations. The newspaper’s stress on the hormonal causes of this condition include the following examples: Melanie Stokes tried for years to have a baby. When she did, the severe hormonal imbalance she suffered after the birth drove her into the little-discussed condition called postpartum psychosis. (Rotzoll, 2001, June 9) After the Feb. 23 birth of her daughter Sommer Skyy, Stokes was in and out of hospitals with a severe hormonal imbalance. (Rotzoll, 2001, June 10)


39 A mild form of hormonal depression called “baby blues” affects about one woman in 10 after birth, doctors say. (Rotzoll, 2001, June 9 ; Rotzoll, 2001, June 10) 4 Laurence Kruckman, a professor of medical anthropology at Indiana University of Pennsylvania, said there are three levels of postpartum depression. The worst is postpartum psychosis, a hormonal condition that affects mothers after one or two of every 1,000 births. (Easton, 2001a, June 22 ; Easton, 2001b, June 22) 5 Sam Stokes said when women are pregnant their progesterone level is three to four times higher than normal. After birth it drops precipitously to a little less than normal. He said the drop in hormone levels probably occurs a few days after birth, but symptoms don’t show up for several weeks. Sam Stokes said it is believed that “some people’s brains are extremely sensitive to hormone fluctuation,” and this is what leads to the more severe forms of depression. (Rotzoll, 2001, June 9; Rotzoll, 2001, June 10) Experts believe postpartum psychosis is triggered by a steep and rapid drop in progesterone levels after childbirth. (Ritter, 2001, June 12) But where’s the outrage that her sickness was treated like a “depression” rather than “postpartum depression”? [sic] The sicknesses are caused by entirely different chemical imbalances. Postpartum depression is a hormonal imbalance, and psychotropic drugs can, and do, exacerbate the problem. (Laney, 2002, March 3) Most of the articles seemed to portray the condition as uncontrollable and the women who suffer from it as mentally disturbed, due to their emphasis on the delusional and hallucinatory aspects of PPP and the unpredictable behavior of the mothers. The out-of-control image of PPP arose from the identification of the typical symptoms and was furthered by description of the often-seen behavior of women suffering from PPP. For example, a medical anthropologist quoted in one article said of women suffering from PPP: “If you are in that category, there is a high likelihood of hallucinations,” said Kruckman, who heads Postpartum Support International. “Mothers hear voices that say kill yourself or kill the baby, or both.” (Easton, 2001a, June 22 ; Easton, 2001b, June 22) 4 Essentially the same story was published two days in a row. 5 The same story by Pam Easton was published in both the Chicago Sun-Times and the Chicago Tribune.


40 Some additional examples that support this image are: Symptoms include hallucinations, hearing voices, paranoia, suicidal or homicidal thoughts, delusions, severe insomnia, extreme anxiety and depression. (Ritter, 2001, June 12) Postpartum psychosis is “generally characterized by periods of very clear thinking. This is why it’s hard to get a handle on it,” Semprevivo said. In between those times of clear thought come “periods of thought disorder and inability to realize reality,” she said. There may be hallucinations, delusions, severe insomnia, agitation. A severely affected woman may refuse to eat. (Rotzoll, 2001, June 9; Rotzoll, 2001, June 10) The newspapers’ portrayal of PPP as beyond control is strengthened when the information noted earlier is taken into account; that is, while the hormonal drop usually occurs several days after birth, symptoms might not show up for several weeks. This lends an air of unpredictability to the condition. Additionally, the variation in brain sensitivity and reaction to the hormone level fluctuations adds to this unpredictable image. The variety in treatment options may play a part in PPP being seen as a difficult condition to control. In Melanie Stokes’ case, it was stated that: She was treated with “everything from anti-psychotic and anti-depressive medications to electro-convulsive therapy,” said her husband, Dr. Sam Stokes, a surgeon at Cook County Hospital. (Rotzoll, 2001, June 9 ; Rotzoll, 2001, June 10) In another article: The recommended treatment starts with hospitalization and can include anti-psychotic, anti-depressant and anti-anxiety drugs and electroconvulsive (shock) therapy, said Dr. Foti Chronopoulos, an obstetrician-gynecologist at Advocate Christ Hospital in Oak Lawn. (Ritter, 2001, June 12) In addition, these women may seem mentally unstable because women in the grip of PPP can be irrational or react in a way that reflects ancient biblical beliefs of soul possession by evil spirits and exorcism. An example describing this is:


41 “A woman might believe she is the Virgin Mary or that her baby is the Messiah. Or she might want to kill her baby because she thinks the child is the devil. She might fear that people are trying to poison her or steal her baby,” said Joyce Venis, president of Depression After Delivery, Inc. (Ritter, 2001, June 12) One article appeared to contradict the other articles that blamed PPD solely on medical or hormonal causes. In this article, medical causes were listed, but other possible factors were noted as well. Societal changes may be increasing the risk of postpartum disorders, said Laurence Kruckman, a medical anthropologist at Indiana University of Pennsylvania. Women who have moved away from their hometowns don’t get much help from grandparents, and new moms who go back to work may feel overwhelmed. “They’re isolated and more vulnerable,” said Kruckman. (Ritter, 2001, June 22) Despite this expert’s claim that the risk of postpartum disorders may be increasing, this same article joined with earlier articles in noting the rarity of PPP by its headline: “Postpartum psychosis rare, but nothing new, experts say.” Another article stated, “Postpartum psychosis is rare, affecting what’s estimated to be only about one in 1,000 new mothers,” (Ritter, 2001, June 12). In addition, it was noted that PPD is not a new condition and that an epidemic was not occurring. An expert was cited to defend this view: “It’s been around since the time of Hippocrates,” said Andrea Dresser, secretary of Postpartum Support International. “It’s just getting more media attention now.” (Ritter, 2001, June 22) Overall, the Chicago Sun-Times defined PPD as a hormonally caused condition that makes its sufferers behave in an uncontrollable manner that made them seem mentally insane. The Chicago Tribune The Chicago Tribune painted a more complex and complete picture of PPD than the other newspapers, in large part because of the significantly higher number of articles


42 published that defined PPD. While in general this newspaper gave more detailed information about PPD, this information was sometimes vague, inconsistent, potentially misleading, and even contradictory at times. This was particularly noticeable when the cause of PPD was noted. Some articles seemed to downplay the seriousness of PPD by using a reassuring tone, stressing the relative commonness of the condition and noting that it is not a pseudo disorder or human weakness. Yet at the same time the nature of this condition as a mental illness was emphasized too, and at least two articles labeled PPP a “psychiatric emergency.” There also seemed to be more of a focus on the danger presented by a woman suffering from PPP. Most of these articles noted the uncertainty of the specific causes of PPD and a few labeled it a mystery disease; hormonal causes were discussed but the later articles focused more on non-biological or more socially related causes and how the community of health care workers, spouses, friends and family could help women with this condition. Articles published before the Andrea Yates event defined the baby blues and PPD, but only in a general sense. They were vague about the differences between the two levels, did not indicate that only 10 percent of women who have the baby blues will develop PPD and did not include PPP in its discussion: The anxiety and irritability that take hold after childbirth are well known as postpartum depression. As many as 80 percent of women have a mild depression called “baby blues” that lasts a week or two before fading. They get cranky, weep easily, take no joy in motherhood, can’t sleep and then feel guilty about all those feelings. The difference between blues and depression? A blue mother given time away from her baby will sleep; a depressed mother will fret and grow worse. (LaMendola, 2000, October 29 ; LaMendola, 2000, November 26) Although most articles published after the Andrea Yates event were more specific in their descriptions of PPD, a few were overly general or potentially misleading. For


43 example, one brief article defined PPD in the following manner, without differentiating PPD and PPP, nor did it mention any hormonal or otherwise non-psychological causes: Family members told police that Melanie Stokes, 41, may be suffering from postpartum depression, a psychological disorder that can cause new mothers to lose touch with reality and become homicidal or suicidal. (“Police and family search,” 2001, June 11) One article only gave one general symptom in discussing PPD: Feingold said symptoms of depression may also include a wish to leave and escape the situation, although the majority of new mothers do not actually go. (Nevala & Yednak, 2001, July 19) Another article was vague when it described symptoms of PPD, simply saying: “The sadness can last months” (Vogell, 2001, June 10). Some articles gave a complete and accurate picture of PPD, while trying to be reassuring and not to scare the reader at the same time by emphasizing that it is a relatively common occurrence and that developing PPP is rare: The mother of a 3-month-old daughter, Melanie Stokes, 41, was reportedly suffering from a severe form of after-birth depression called postpartum psychosis, an extremely rare biological response to rapidly changing hormonal levels that can result in hallucinations, delusions, severe insomnia and a drastic departure from reality. Virtually all new mothers get postpartum blues, also called the baby blues, which are brief episodes of irritability, moodiness and weepiness. About 20 percent of birthing women experience postpartum depression, which can be triggered by hormonal changes, sleeplessness and the pressures of being a new mother. It is often temporary and highly treatable. But what officials suspect Stokes was battling, postpartum psychosis, is even more extreme and is considered a psychiatric emergency. (Deardorff & Hepp, 2001, June 12) But a common response for most women who have just given birth—not just an unlucky few—is a form of depression rooted in chemistry and biology. Their bodies are responding to sudden hormonal changes. Most recover on their own in a short amount of time, especially if they are allowed to rest and if they have help tackling the overwhelming demands of a newborn. Those who have more severe symptoms than simply feeling blue usually respond to treatment, which may include medication or, in some cases, hospitalization. Melanie Stokes, 41, the mother of a 3-month-old girl, suffered from the rare postpartum psychosis, which one in 1,000 new mothers develops. (“Postpartum risks,” 2001, June 15)


44 Today though, Gindorf has support from a host of national experts who say she was suffering from what is now called postpartum psychosis, an extremely rare mental illness following childbirth. (Deardorff, 2001, June 24) Some articles also iterated that this is a real condition: During postpartum psychosis—a very real disorder that affects less than 1 percent of women, according to the National Institute of Mental Health—a mother might hear voices, have visions, feel extremely agitated, and be at risk of harming the child or herself. (Deardorff & Hepp, 2001, June 12) The key factor is we now understand the biology of depression, and that it is less associated with human failing. (Condor & Brotman, 2001, June 27) Some Chicago Tribune articles described PPD as a dangerous or mysterious condition that is often ignored: A mother with Stokes’ illness may be dangerous. She can suffer hallucinations and delusional beliefs about her infant. There have been tragic cases of infanticide by mothers suffering from this disorder. (“Postpartum risks,” 2001, June 15) A more dangerous form of the “baby blues,” the disorder causes the women who suffer from it—about 1 in 1,000 new mothers—to lose touch with reality and potentially turn suicidal or homicidal. (Vogell, 2001, June 10) More than 2,400 years after Hippocrates first described the symptoms of postpartum depression, scientists around the country are taking some of the first steps toward understanding what causes the mysterious ailment. “This is a major public health problem that we still don’t pay much attention to,” said Dr. Katherine Wisner, a professor of psychiatry at the University of Louisville and a leading researcher on the causes of postpartum depression. The enigma of postpartum depression is deeply linked, experts believe, to the basic hormonal differences between all men and women. (Manier, 2001, June 23) Although many articles attributed hormones as at least a partial cause of PPD, it was noted that much is still not known about the condition and that other reasons may also cause it: The major hormonal shifts that occur before and after birth are partly to blame, experts said, though the syndrome is not well understood. Hormonal changes, sleeplessness and the pressures of being a new mother all can contribute to the condition said another obstetrician-gynecologist. (Vogell, 2001, June 10)


45 Among the basic questions that scientists have yet to answer is to what extent postpartum depression stems from the huge hormonal changes women go through after delivering a child. Some psychiatrists argue that such chemical effects are minor compared with the stress and sleep deprivation that most new mothers experience. (Manier, 2001, June 23) Traditionally, doctors have blamed PPD on the dramatic drop in hormones that occurs after delivery. But chemistry can’t explain everything; otherwise, all new mothers would plummet into depression. According to the latest research, women who suffer from PPD show clear warning signs during pregnancy; many have risk factors, such as a history of depression. (Sammons, 2001, October 21) Overall, the Chicago Tribune gave a thorough explanation of PPD, while acknowledging the shortcomings of current knowledge about the condition. The Houston Chronicle The Houston Chronicle appeared to focus more concern on the potential violent aspects of PPD. The newspaper tended to emphasize that this was usually a manageable condition that was not very serious nor led to violence, perhaps to reassure new mothers and allay the public’s fears in the wake of the Andrea Yates drownings. This newspaper also seemed to cast doubt on the causes of PPD, particularly whether it or not it was hormonally caused. Social causes were generally included along with medical ones. In general, however, the newspaper defined PPD in enough detail for the reader to come away with a fairly good understanding of the condition. The following examples show the emphasis on PPD as a mild condition and the rarity of its role in any kind of violence, but noting that in severe cases violent action is possible. Medical experts were usually the sources for this information: “Postpartum depression is very common and usually very mild and manageable,” said Dr. Edward Yeomans, an OB-GYN and UT-Houston professor of maternal-fetal medicine. Dr. Lauren Marangell, a Baylor professor of psychiatry and behavioral sciences, added that most people suffering from depression don’t harm other people. But she said it can happen in severe cases, particularly if the patient has a degree of psychosis. (Ackerman, 2001, June 21)


46 It can cause feelings of confusion, panic and hopelessness as well as changes in eating and sleeping patterns. It is usually mild and responds well to treatment, but in rare, severe cases it has led to violence. (Glenn et al, 2001, June 21) Experts say that up to 80 percent of all new mothers experience brief bouts of the postpartum blues. By day 14, however, most women are back on an even keel. Their hormones have adjusted, they have found new coping skills, and they are full of love for the newest member of the family. Family and friends should intercede, however, if the tears don’t stop, and a woman spirals beyond the postpartum blues to level two of the mood disorder—postpartum depression—or level three—postpartum psychosis. (Feldman, 2001, June 26) The Houston Chronicle conveyed that the causes of PPD were still not understood completely and that the role of hormones is debated: The cause of postpartum depression is not well understood. Hormonal changes are often cited, but Yeomans and Marangell said that though individual women might be sensitive to progesterone levels dropping soon after childbirth, there is no convincing evidence of hormonal changes a month later, when postpartum depression begins to occur. They added that no treatment involves hormones. (Ackerman, 2001, June 21) “Whether it’s postpartum depression is not the issue,” said Dr. Lauren Marangell, head of the Baylor mood disorders program. “We don’t know enough to say at this point. Depression is a brain-based disorder that is usually treatable and that doesn’t typically lead to homicide. Stressful life events can worsen depression or psychotic disorders, and treatment is essential.” (Ackerman, 2001, June 22) Other causes besides medical causes were noted, too: After giving birth, a woman’s hormones, electrolytes and fluids are in flux—those are the biological reasons for the mild depression, doctors say. There are practical reasons too. New moms find themselves tied to home and hearth, like it or not, and they face new financial challenges, new family dynamics, new worries about their appearance and competency. (Feldman, 2001, June 26) Only two of the four Houston Chronicle articles clearly delineated the three stages of PPD. But the newspaper did give typical symptoms, the length of duration of these symptoms, and the number of new mothers typically affected. Some examples follow: Postpartum depression affects roughly 8 to 15 percent of mothers. Starting about four weeks after birth and lasting for months, it can cause feelings of confusion, panic and hopelessness as well as changes in eating and sleeping patterns. Postpartum depression is distinguished from postpartum blues, which usually


47 appear a few days after birth and disappear within a couple weeks. Marked by anxiety and oversensitivity, it is milder and shorter in duration than postpartum depression. A third condition is postpartum psychosis, in which the sufferer loses touch with reality. Occurring in 1 to 4 of every 1,000 women who give birth, it can lead to hallucinations and thoughts of violence, particularly suicide. (Ackerman, 2001, June 21) Vincent said the incident sounded like postpartum psychosis, an extremely rare (1 to 4 in 1,000) condition in which the mother loses touch with reality and often experiences hallucinations or delusions. (Ackerman, 2001, June 22) It [PPD] resembles any other kind of depression, Puryear says. “The new mom may be tearful, irritable, unable to sleep, with a poor appetite, decreased energy, and no interest in her usual activities.” In rare cases—one in 1,000, Puryear says—depressed mothers become psychotic. “When it’s so severe, women may hear voices, they’re delusional and their thoughts are very confused. In those cases, there’s excessive worry about the children and thoughts of harming them.” Dr. Jay Tarnow, another Houston psychiatrist, agrees. “With psychosis, people are paranoid, they’re out of touch with reality, they hear voices—they may even hear God telling them to do something.” (Feldman, 2001, June 26) Overall, The Houston Chronicle defined PPD thoroughly enough for the average reader to come away with a basic understanding of the condition. The New York Post The New York Post did not define PPD at all. Their articles barely mentioned any kind of definition for PPD, and the only exceptions were vague or misleading, such as a reference to hormones or appearing to equate the more severe forms of PPD with the baby blues. One columnist said: Sure my hormones were raging, sure I felt somewhat off-kilter. But I’ll say this. Never once did I ever entertain the thought of ever striking my child, let alone take his life. (Gotti, 2001, July 1). One article merely called PPP (without labeling it by name) “a rabid form of postpartum depression” (“Yates lawyers,” 2001, July 4). Other than these references, The New York Post did not describe PPD more explicitly.


48 The New York Times The New York Times also was general and vague about PPD. The newspaper typically just referred to Andrea Yates’ condition with variations on the generic terms of “mental illness,” “postpartum depression,” or “postpartum psychosis” (or just “depression” or “psychosis”) and focused on other topics. Any explanation beyond these terms usually was not found. One rare exception was a very brief description included as part of Andrea Yates’ defense lawyer’s reported opening trial argument: In opening arguments, Mrs. Yates’s [sic] lawyer, George Parnham, described his client as a loving caring mother who schooled her children at home but succumbed to psychosis that caused her to suffer delusions and lose touch with reality. He cited her history of mental illness, including past diagnoses for postpartum psychosis, which affects a small number of mothers of new babies. (A less severe ailment, postpartum depression, is more common). (Yardley, 2002, February 19) In another article, although it did not define PPD according to the qualifications laid out earlier in this study, the columnist (also a psychologist) did discuss PPD in general terms. The levels of PPD, with accompanying statistics, were mentioned as well. Eighty percent of all new mothers experience the baby blues; one in 10 new mothers develop from this a full-blown clinical depression, and one in 1,000 develop psychosis, which is 16 times more common during the postpartum period than at any other point. More to the point, postpartum depression may be a hormone-related syndrome, but a syndrome is not just a “chemical imbalance.” A syndrome is a complex cascade of biological events that have a recursive relationship to the individual and the culture in which these events are made manifest (Slater, 2001, July 8) In general, however, The New York Times simply did not define PPD for the general public. The St. Petersburg Times The main thread that ran through the St. Petersburg Times articles was its emphasis on the commonness of PPD, as well as the treatability of PPD. The medical cause of the condition was emphasized, rather than social factors, although the lack of consensus on


49 medical causes was noted. The usual behaviors of woman suffering from PPD were described also, although more simply than the other newspapers that defined PPD, with only one article differentiating the three levels. Examples of PPD being considered a fairly common condition, and one that is treatable, included the following: The ailment, a hormonal reaction to having a baby, is the most common complication related to childbirth, said Andrea Dresser, the secretary of Postpartum Support International. (Davis, 2001, April 16) As many as 80 percent of all postpartum women get the “baby blues”—fatigue and anxiousness that dissipate after a couple of weeks. But as many as 30 percent of new mothers develop more serious depressions requiring help, says Honikman. (Aschoff, 2001, April 18) While the St. Petersburg Times focused on the medical view of the causes of PPD, it also noted that these causes are not completely known yet: The causes of postpartum depression are not fully understood. It may occur when abnormally high levels of estrogen and progesterone during pregnancy suddenly fall after childbirth. Meanwhile, adrenaline surges through a woman’s body in a preprogrammed “protector” response to the infant, experts say. Studies show there is an increased risk if there is a history of mental illness in the family. (Aschoff, 2001, April 18) Interestingly, this newspaper also noted one correlation between Caesarian sections and PPD that was not mentioned in any of the other newspapers. It was the only non-medical cause that was mentioned by the St. Petersburg Times: Gifford would be at higher risk for depression because she had a Caesarian section, Dresser said. (Rebekah was in the breech position.) Some experts think an inability to deliver naturally contributes to feelings to inadequacy. (Davis, 2001, April 16) The St. Petersburg Times described typical thoughts and behavior of a mother suffering from PPD: It leads mothers to believe they can’t cope, aren’t good parents and can’t bond with their baby, Dresser said. In the most severe cases, it can cause mothers to flee their families and make them suicidal. (Davis, 2001, April 16)


50 The women she sees, she said, “are usually feeling very guilty over not being happy about the new baby. They’re often quite agitated and feeling inept and worried that they’re not going to be a good mother and worried that they have already failed the baby (because) they don’t feel as connected as they should.” And they’re often women, Dr. Haney said, who expect perfection of themselves and nothing less. So they cannot forgive themselves for their roiling emotions. (Melone, 2001, April 22) The variety in behavior displayed by women with PPD also was noted: A sufferer may be hyperactive and anxious or lethargic and weepy. Some experience panic attacks. Others have nightmarish fantasies about mutilating their baby. “We have a woman who washed the baby until its skin came off,” says Arlene Huysman, a clinical psychologist in Miami and the author of A Mother’s Tears: Understanding the Mood Swings That Follow Childbirth [sic]. (Aschoff, 2001, April 18) Overall, the St. Petersburg Times gave a general idea about PPD and its symptoms and causes, but was not as specific or in-depth with detail as most of the other newspapers that defined PPD. USA Today USA Today barely paid any attention to the issue of PPD, but the little information it gave was more accurate and complete than that given by some of the other newspapers. The newspaper also used a reassuring yet matter-of-fact tone to explain PPD and included social as well as medical causes in its definition. The only USA Today article that defined PPD did so concisely but gave enough information for the reader to come away with a basic understanding of PPD. The story differentiated the three levels of PPD and clarified some points that might confuse readers, such as the danger these mothers pose to their children and themselves, how these levels relate to each other, and the various causes. Some examples of these clarifications are: One in 10 mothers are diagnosed with postpartum depression each year, but only one in 1,000 deteriorate to the point where they would become so delusional they could endanger their child, experts say.


51 It [PPD] is triggered by a mix of hormones and other factors, including weak family support and isolation, she says. Women diagnosed with postpartum depression often have a history of depression or are suffering financial difficulties and trouble in their relationships, says Sanford, who wrote the book Postpartum Survival Guide. “They have trouble eating, sleeping. They’re anxious and feel guilty about not being a good enough mom,” Sanford says. Eventually, some become suicidal. Few women with postpartum depression become psychotic, Sanford says. Many of these women have a history of untreated depression or psychosis. By some estimates, there are about 80-120 cases of mothers with postpartum psychosis killing their children each year in the USA. There often is confusion about postpartum depression for women. Three separate conditions sometimes occur after childbirth. One condition, if it does arise, does not necessarily lead to another. (Angle, 2001, June 22) Another article published by USA Today cited a psychiatric professor’s statement that there are gradations of severity of PPD and violent acts are unlikely (Jones, 2001, June 22). However, by the qualifications laid out earlier in this study, it was not considered to define PPD. Stakeholder Definitions This section takes a closer look at the stakeholders’ definitions of PPD. Across the newspapers, stakeholders repeated similar words and phrases to describe and define PPD in its varying manifestations. These media primarily used medical experts as sources to define PPD; however, in some cases, institutions such as the National Institute of Mental Health and the American College of Obstetricians and Gynecologists were used as information sources. Typically, these experts were psychologists or psychiatrists, but obstetrician-gynecologists (OB-GYNs) frequently were used as well. Characteristically, medical experts framed PPD with most of the symptoms already described, focusing on biological causes. These


52 experts often pointed to steep hormonal fluctuations (particularly progesterone levels) after childbirth as a major culprit in causing PPD. Sometimes medical experts mentioned societal changes as another factor in causing or worsening the disorder. For example, one clinical psychiatrist who wrote an opinion piece for The New York Times defined PPD as being biologically caused and described the rapid fall of hormone levels after childbirth, but also stressed cultural influences such as a lack of a social support system for the new mother (Slater, 2001, July 8). This commonly is associated with the stress and coping model described in the literature review. Medical experts sometimes were portrayed as trying not to alarm the public when discussing PPD, perhaps in an effort to de-emphasize the dangerous aspects of the condition. An example of this comes from The Houston Chronicle: Here and around the country, obstetricians, gynecologists and psychiatrists struggle to put the Yates case in perspective. They don’t want the public to think that every new mother with the baby blues is suicidal or homicidal. But, they say, more attention should be paid to the mental health of new moms. (Feldman, 2001, June 26) Legal experts also were an important source for the newspapers. Legal stakeholders tended to define PPD generically in terms of “mental illness,” “mental condition,” “mental problems,” “state of mind,” and “not in her right mind.” Rather than delving into the medical aspects of the condition, they focused on the legal aspects of proving PPD by degree of insanity. Special interest stakeholders included advocates and activist groups such as the NOW, ACLU, and anti-death penalty groups. NOW focused on raising awareness about the disease, called for more research into the illness, and urged the judiciary to take into context the nature of PPD when deciding how to handle Yates’ case. They never referred


53 to Yates’ actual deeds other than to label the drownings of the children a tragedy. The ACLU and anti-death penalty groups did not define PPD—their main focus was to draw attention to the issues they supported, such as individual civil rights and abolishing the death penalty. They used the publicity surrounding Andrea Yates to draw attention to their causes. One spokeswoman for the ACLU did note her sympathy for Andrea Yates, emphasizing her disbelief in imagining what Yates must have been going through “to take that kind of action” (Parker, 2001, August 28). The general public was also a stakeholder in Yates’ case. The voice of the public consisted of people who were quoted for stories and was conveyed through sources such as neighbors, visitors to the Yates’ house and/or the children’s funeral, high school friends, and family members of Andrea and Russell Yates. Columnists, editorials and op-ed writers rounded out the sources for general public voice. The voice of the public was divided into those who felt Andrea Yates should be held accountable for killing her children versus those who called for understanding the condition Andrea Yates was suffering and the circumstances surrounding her actions, and stressing the need for treatment over judgment. Some also questioned the responsibility and role that her husband Russell Yates played in this scenario, as well as whether the medical establishment had done enough to prevent the situation from occurring. A few people blamed managed care health insurance companies for denying or short-circuiting coverage of mental illness treatment. Thus, the public voice blended the views of the medical model with the stress and coping models discussed earlier.


54 Research Question 2: How Have the Media Framed PPD in the Recent Controversy and Coverage Stemming from the Andrea Yates Case? Seven frames were found to be the most dominant throughout all of the newspapers. These were: Battle Blame Jekyll and Hyde Legal Medical Society Storyteller Table 4-3 lists the most common frames that recurred frequently throughout the newspapers analyzed for this study. Table 4-3. Frames. Frames Battle Blame Jekyll & Hyde Legal Medical Society Storyteller Subcategories Publicity Shame Support While many stories could be categorized as falling under a single frame, most stories used two or more frames intertwining with each other throughout the context of the story. In this section, each frame first will be explained briefly, and then following, a more complete description of the frames will be given with specific examples from the newspapers for every frame. The Battle Frame included any elements of conflict in a story, and use of war terminology especially to describe events and stakeholders. The Blame Frame was used in articles to cast blame on one or more particular persons or institutions for a certain problem. The Jekyll and Hyde Frame portrayed Andrea Yates and other mothers who had killed their children as either insane or evil, with these women depicted as falling on


55 opposite sides of a behavioral spectrum; where on one side they were seen as a fallible human who has gone mad and on the other side, portrayed as an evil being, depending on the bias of the writer. The Legal Frame mainly focused on legal issues and events surrounding Andrea Yates’ trial. The Medical Frame included all medical information given about PPD and medically related issues revolving around Andrea’s case or highlighting the other women’s struggles with PPD. The Society Frame was used to discuss societal causes and effects. This was a very broad frame that also encompassed several major subcategories. These subcategories included: Publicity, Shame, and Support. Stories that made use of this frame discussed how the Andrea Yates case or the PPD issue affected society at large and/or the local community, often focusing on the specific subcategories. The Storyteller Frame spotlighted the human-interest factor. This frame was used to convey a story-like or movie-like aspect to an article to personalize it and to capture the reader’s attention. The Battle Frame Most often the Battle Frame was used in reference to legal issues, usually by portraying the opposing legal sides in the Andrea Yates case as adversaries in a battle. Words such as “strategy,” “attack,” and “battle” were common in this frame. Many times the Battle Frame focused on the issues of the death penalty or arguments made by the prosecution (the state of Texas) versus the insanity plea and arguments made by the defense (Andrea Yates). However, this frame was used for other issues as well, such as pitting Rusty Yates against societal disapproval of his perceived inability to help his wife and prevent the drownings of their children.


56 The Chicago Sun-Times used the Battle Frame in a story about Melanie Stokes, in which her father was framed as battling PPP taking over his daughter’s mind and Stokes is portrayed as being attacked by this condition: But when this father ran up against postpartum psychosis, he found himself ill-equipped to battle a condition few people knew about. Melanie Blocker Stokes was struck with postpartum psychosis after giving birth to her first child. (Mitchell, 2001, July 20) Battle-like terminology was used in a Chicago Tribune story about Rusty Yates’ testimony during Andrea’s trial, showing him and the prosecution at odds over his role as a husband: Russell Yates on Thursday fended off a prosecutor’s apparent attempt to portray him as a domineering husband, saying he and Andrea were partners in all major decisions in their marriage. (“Yates says,” 2002, March 1) The Houston Chronicle published an article about the legal issues in this case that would be brought up in trial, which portrayed the opposing legal sides as preparing for battle. The following quote used the image of preparing for war: “lawyers for Andrea Pia Yates filed a notice of intent with the 230th State District Court that they plan to mount an insanity defense.” Later in the same article more battle terminology was used: Burnett said prosecutors could also be holding back as a legal maneuver. “As a matter of strategy, you want to maximize your chances, have two bites at the apple if you will. That could be their strategy,” Burnett said. (Teachey, 2001, July 31) In one The New York Post article, the Battle Frame was used in reference to Andrea and Rusty Yates’ marriage: Andrea Pia Yates’ oldest brother, Andrew Kennedy, said his sister had battled depression and a crumbling marriage for years, but her father’s slow, agonizing death from Alzheimer’s pushed her over the edge. (Hunter, 2001, June 24) In a different The New York Post article, the reporter used a visual image from modern-day wars to describe the Yates case at the beginning of Andrea’s trial: “the case is a


57 minefield of controversial issues: infanticide, insanity, and execution” (Connor, 2002, January 8). An editorial for The New York Times depicted the trial as a courtroom win-or-lose battle about two different issues, using terminology from a card game: What, in effect, happened in that courtroom is that while the defense tried to make the case about mental illness, the prosecutors made it about motherhood—and motherhood trumped mental illness. (Fleming, 2002, March 17) The St. Petersburg Times published a column in which battle terms were used throughout the story about two women’s groups at odds with how Andrea Yates was being treated. This included items like: “the escalating debate;” “the two groups are engaged in a bitter back-and-forth;” “who has made a career out of attacking the liberal doctrine of NOW and other such groups” (Fritz, 2001, September 10). And one USA Today columnist used the Battle Frame when describing how the public’s view of Andrea Yates shifted over time as more details of her history were publicized: Yates has quickly gone from being viewed as the author of an incomprehensible atrocity to a casualty in the psychological war of modern motherhood. (Holmes, 2001, June 29). The Blame Frame The Blame Frame was used most noticeably in many editorials or opinion columns, which often employed sarcasm, skepticism, defensiveness, and a judgmental tone as methods of indicating who the writer held responsible for an issue or event. For example, Rusty Yates often was held responsible for his wife’s actions, as were the medical doctors and psychiatrists who treated her. Blaming hormones or lack of familial and/or societal support for the behavior of Yates and other women suffering from PPD was another way in which the Blame Frame was utilized. Voicing sympathy for Yates, her


58 husband, or the main person in a story also was a way in which blame either was exonerated or insinuated for another person or institution. The Blame Frame was employed in conjunction with another frame in most of these newspapers’ stories, many times with the Jekyll and Hyde Frame. Blaming was most often stated or insinuated by those who believed that Andrea Yates should be punished and put to death. Extreme skepticism and sarcasm were evident throughout their pieces, with much ridicule and belittling, often of the woman suffering from PPD and especially of Andrea Yates, but also of those who sympathized with her. Two different New York Post columnists demonstrated this: Say, ever feel depressed after giving birth to kids? Hey, Andrea Yates was depressed too! So was the fabulously toothy Marie Osmond—though she didn’t kill her own children. But think about it. Andrea Yates, Marie Osmond. Are you next? (Podhoretz, 2001, June 26) To hear the defense tell it yesterday, Yates did not kill her babies, she “interrupted their lives.” When Yates chased down her five kids and held their struggling heads under water, one by one, until they stopped breathing, it was not murder. It was an “incident.” How can a woman in her right mind kill her children? You heard “experts” from Marie Osmond to Katie Couric weigh in on this one; she can’t. (Peyser, 2001, February 19) Many articles from The New York Post made extensive use of the Blame Frame, often with graphic and judgmental wording. Whereas most of the newspapers usually referred to the death of the Yates children in more generic terms such as “drownings” or “death,” The New York Post tended to favor more graphic words such as “killed,” “murdered,” and “slaughtered.” The New York Post ran the most inflammatory and blaming headlines of all the newspapers, most often referring to Andrea Yates as “Killer Mom.” An example of one headline that set the tone for the Blame Frame was: “A deadly excuse; the peril in blaming depression for Yates’ crime” (Podhoretz, 2001, June 29).


59 Postpartum depression itself also was denigrated as a legitimate condition. For example, a writer for The New York Post wrote: Which is why I am worried that the focus on postpartum depression in the wake of the Andrea Yates case threatens to inaugurate a new American hysteria not dissimilar from the child-care witch-trial atmosphere of the 1980s and early 1990s. For the sake of a true public understanding of postpartum depression, Andrea Yates must not be granted the benefit of that false diagnosis. (Podhoretz, 2001, June 29) Writers using the Blame Frame frequently questioned the potentially serious consequences of the condition. One example from The New York Post follows: There are almost 50 million children in the United States—and in any given year, 200 of them are killed by their mothers. That’s one in every 250,000 children. Which means, basically, that it never happens. (Podhoretz, 2001, June 26) Doubt often was cast on whether PPD could cause such behavior as suicide or infanticide, especially when the columnist compared her own experience after childbirth. One columnist for The New York Post voiced her skepticism about the seriousness of PPD by writing: And that’s why the slaughter of her children by Andrea Pia Yates is so impossible to comprehend. Postpartum depression should lead to chocolate, not infanticide. (Stasi, 2001, July 1) A different columnist said: The Yates children came face to face with evil in its purest form. Not post-partum [sic] depression; after all, millions of women suffer from post-partum depression and do not kill their kids. (Podhoretz, 2001, June 26) Another columnist for The New York Post who was particularly vehement in her columns about Andrea Yates’ responsibility, used the Blame Frame and sarcasm to question what she saw as the misplacement of blame in Andrea Yates’ case and to discredit the influence of PPD: These facts are being used to excuse her, by people who haven’t a clue about what went through Yates’ mind. One has to wonder why Yates’ husband, knowing his


60 wife’s mental state, allowed her to home-school the children. Such things may explain depression. They cannot, and should not, be used to excuse a hideous crime. Still, blaming a mother for murder is heresy among the talking heads who fill the airwaves with psychobabble about post-partum [sic] depression. (Peyser, 2001, June 28) The Blame Frame was common in other newspapers as well. In USA Today, one writer editorialized: The one person in the world we expect to be most responsible for the safety of children, their mother, brutally overcame her resistance and violently killed them one by one. It didn’t make any difference to these happy innocent children whether their mother was legally sane or crazy. These youngsters were robbed of their lives. (McNamara, 2002, March 12) Another USA Today story with the headline, “It must be asked: ‘Where was the dad?’ Difficult questions haunt father of drowned children,” quoted several neighbors who looked askance at Rusty Yates’ behavior and appeared to infer his responsibility for Andrea Yates’ deeds: “She was overwhelmed and nobody heard her cries. He definitely missed clues,” Allen says. “I don’t know what was going on behind that door, but her husband is probably asking himself, ‘What could I have done to stop this?’” (della Cava & Oldenburg, 2001, July 3) An editorial in the Chicago Tribune also incorporated the Blame Frame in its discussion of Rusty Yates: Within six months after child No. 5 [sic], the robotic and withdrawn Andrea Yates went over the far edge, and her husband appeared before television cameras as though he were discussing his winning golf stroke. “I’m mad at her for killing the children,” he said, or words to that effect, “but then I’m not mad at her because I know she wasn’t herself.” Somehow I kept expecting his next words to be, “Andrea was just having a bad day.” Actually, Andrea was having a very bad life and her husband bears some moral, if not legal, responsibility for that. (Parker, 2001, August 15) A story from The New York Times appears to infer some blame on Rusty Yates’ part for pushing his wife to return home sooner than she may have been ready to, when


61 describing comments made by a therapist for Yates’ medical chart during one of her hospitalizations: Near the end of the stay, Mr. Yates became “very eager” for his wife to be discharged and “is putting some pressure on her” to leave the hospital, a psychologist wrote, noting that Mrs. Yates would continue outpatient therapy. “He reports Pt. [sic] is 90-95 percent back to normal; she reports it’s more like 70-75 percent,” the psychologist wrote. (Yardley, 2001, September 8) The New York Times published an editorial that blamed the people who knew Andrea Yates but did not do enough to help her: But what of the rest, the people who stood by and watched her disappear into madness, those close enough to see beneath the gauze of motherhood? What could they, what should they, have done—the relatives, friends and doctors—all of whom say they knew she was unstable? They made stabs at helping, but not enough to avert tragedy. (Fleming, 2002, March 17) In a different USA Today story, Rusty Yates is quoted as blaming the medical establishment for Yates’ behavior: “‘The medical community failed us,’ he told 60 Minutes” (Parker, 2002, February 18). In The Houston Chronicle’s first article to give information about PPD, there was initial skepticism by two experts, an OB-GYN and a psychiatrist, that PPD was the true cause of Yates’ behavior. This skepticism is framed from the beginning in the headline, “Postpartum depression’s role doubted.” Two medical experts warned Wednesday against jumping to the conclusion that postpartum depression played any role in Andrea Yates’ alleged killing of her five children. Saying the case’s initial facts more likely suggest an underlying psychological illness. Yeomans said he was skeptical Yates had postpartum psychosis because she called police and her husband after the killings. (Ackerman, 2001, June 21) The Jekyll and Hyde Frame Columnists or guest editorialists, rather than hard news reporters, employed the Jekyll and Hyde Frame most often. Typically, these articles were written from a personal


62 point of view, telling about individual experiences with PPD or motherhood. Some of the writers used this frame to claim that Yates was innocent because she couldn’t have known what she was doing (the Jekyll part of this frame), with a “mad mother” theme emerging. Words such as “crazy,” “zombie,” and “child-like” were used frequently to describe Yates and these women. “She was not in her right mind” and variations on this phrase came up very frequently in these columns. In contrast, some writers described Yates and women in similar cases as exactly the opposite, portraying them as evil beings (the Hyde part of this frame). Terms that came up frequently in this depiction were “devil,” “barbaric,” “alien,” “heinous,” and “monster.” Underlining these stories often was a moral or religious theme, or a black-and-white judgmental view. The Jekyll and Hyde Frame was another frame most likely to be found as an underlying theme in conjunction with another frame, such as the Blame or Storyteller Frames. The Jekyll and Hyde theme often surfaced through quotes by close family members of the affected woman. This was used to describe or explain how the person they knew and loved never would have done such actions, but that something else had to have taken over their brains or personalities. The Jekyll and Hyde Frame comes up clearly in a quote by a PPD medical expert for the Chicago Sun-Times, where she noted that women suffering from PPP “can look very disturbed one hour and the next hour have a logical conversation with you” (Rotzoll, 2001, June 9). In the Chicago Tribune, Melanie Stokes’ mother said of her daughter’s PPP: “That was a monster in my daughter’s brain.” She goes on to emphasize that the person who killed herself “wasn’t Melanie. It was postpartum psychosis” (Deardoff & Hepp, 2001,


63 June 12). The image of Melanie Stokes as an unfeeling zombie-like creature or a “Hyde” is further shown by the following quote from the same article: Stokes showed no emotions toward her daughter once she was born, said her mother, Carol Blocker. “I could see that bonding love wasn’t there,” she said. “Melanie kept telling me that it was hopeless. She said that ‘You have no idea what’s happening inside of my brain.’” In a later Chicago Tribune article, this one about Andrea Yates, her husband, Rusty, stated that “the woman here is not the woman who killed my children,” and “I think that she obviously wasn’t herself and that will come out” (Easton, 2001b, June 22). This became an oft-repeated theme in articles about Andrea Yates--by her husband, family, lawyers, and friends--that “she was not herself.” Another example of the Jekyll and Hyde Frame emerged in a column by a St. Petersburg Times writer who described her struggles with PPD: A childbirth and postpartum doula, or assistant, Burkart’s expertise and her “common sense” were ravaged by postpartum depression. It can be very scary. (Aschoff, 2001, April 18) The Jekyll and Hyde Frame was used most often in The New York Post articles. One writer who described Yates’ state of mind during the drownings as “demonic madness” further emphasized the evil aspect of the Jekyll and Hyde Frame by saying: She was an executioner of her own children, pure and simple—methodical and deadly. She is a monster. Whatever her emotional trials and difficulties, she did something that has no analogue in the annals of history or myth. Even Medea, the archetypal infanticide mother, only killed two of her sons. (Podhoretz, 2001, June 26) Another New York Post writer also made use of the Jekyll and Hyde Frame, while using sarcasm and quotes to delegitimize and cast skepticism on the gravity of PPD and casting blame on Andrea Yates: Evil is the only word to describe Andrea Yates. Postpartum depression? Come on. I’ve had five pregnancies, and each time went through the “Am I getting too


64 fat?” “I have no time to sleep,” and the “All this baby does is cry” phase. (Gotti, 2001, July 1) A writer for The New York Times alluded to a Jekyll and Hyde view of Andrea Yates becoming an evil being when she said, “She was, in short, the ultimate maternal failure turned murderer, the demon mother writ large,” (Fleming, 2002, February 17). The Legal Frame The Legal Frame included debates about use of the insanity plea and the death penalty, their application, success or failure in previous cases, and how these arguments would affect Yates’ chances of being found guilty or innocent of the deaths of her children. Jury selection, case updates and other trial issues (e.g., the gag order issued by the presiding judge in this case) also were included in this category. Law experts and lawyers were the main sources for the Legal Frame. An editorial from The Houston Chronicle used the Legal Frame in stating: Some hold the opinion that prosecutors do not really want to see Andrea Yates sent to death row, but are more interested in impaneling tough jurors who would be less sympathetic to the insanity defense Yates’ lawyers plan to mount. This tragedy raises a host of questions about the role mental illness might play in the commission of crimes and about how such issues should be dealt with within the criminal justice system. (Staff, 2001, August 12) A different article from The Houston Chronicle described the death penalty and its impact on Andrea Yates’ case: The stakes are even higher in the case of Yates. District Attorney Chuck Rosenthal’s decision to ask for the death penalty may make sense in Harris County, the capital of capital punishment in the United States, but it is almost unheard of elsewhere for this type of crime. (Tolson, 2001, September 10) The New York Times published an editorial by a public health lawyer discussing the insanity defense and its context in Andrea Yates’ case: The Yates case exposes serious flaws in how Texas—like most other states—determines criminal responsibility. Under an insanity defense, Mrs. Yates was


65 required to prove in her trial not that she was sane at the time of the killings, but that she did not know she was committing a crime or doing wrong. Her plea of not guilty by reason of insanity would have been highly persuasive if the standard were her ability to conform her conduct to the law. By the prevailing legal standards, however, how she felt and her ability to control her behavior could not be taken into account. (Bard, 2002, March 13) Another article from USA Today that made use of the Legal Frame and talked about the insanity plea in relation to Yates’ case said: Yet the eight women and four men who convicted Yates did not have to decide what the mountain of evidence about Yates’ mental illness may have meant. Under Texas law, the jurors had to focus on a narrow question: Did Yates know right from wrong when she killed her children? And prosecutors presented strong evidence suggesting Yates knew that what she had done was wrong in the eyes of society. (Parker, 2002, March 15) After the trial began, most articles focused on the daily testimonies and legal arguments given. The Medical Frame Discussion of biological and hormonal causes, symptoms, and treatment of PPD, as well as calls for changes in how the medical field handles PPD cases, were predominant in the Medical Frame, with medical experts used as sources to reinforce this frame. This frame was used mostly in articles focusing on PPD as the main topic of a story or in relation to Yates’ mental state for her case and trial. The Medical Frame was the most commonly used frame for discussing the specific issue of PPD itself, due to the reliance on medical experts as sources who described PPD as a medical condition. The Medical Frame was not the most frequently used frame when all the topics (not just PPD) covered in all of the articles are taken into account (i.e., the children’s funeral, the trial, or social causes of PPD), but it was the second most commonly used frame when looking across all topics brought up in the newspapers. While many experts used the words and phrases described in the results for research


66 question 1, they often sought to reassure the public as well. Many medical experts stressed that PPD is a fairly common response after childbirth. The St. Petersburg Times quoted a psychiatric expert who stated that postpartum depression is quite treatable with counseling and medication. “That,” she said, “should be the take-away message” (Melone, 2001, April 22). One Chicago Tribune article used the Medical Frame to demonstrate that pregnant mothers have become medically savvy, yet still are not fully informed about the risks and effects of PPD: But today, pregnant women often know more about placenta previa, which happens in one out of 200 births, than postpartum depression, which strikes one and two women out of 10, said Diane Semprevivo, director of the Perinatal Mental Health program at Advocate Good Samaritan Hospital in Downers Grove. “We tell people, you could hemorrhage, you could do this, you could do that,” said Semprevivo, who always brings up mood disorders in the prenatal classes she runs. “But when I approach health care providers about postpartum depression, I say, ‘Why don’t you tell them?’ They say, ‘We don’t want to scare them.’” (Mellen, 2001, June 27) An article from The Houston Chronicle focused on the Medical Frame when it stated the following: Here and around the country, obstetricians, gynecologists and psychiatrists struggle to put the Yates case in perspective. They don’t want the public to think that every new mother with the baby blues is suicidal or homicidal. But, they say, more attention should be paid to the mental health of new moms. (Feldman, 2001, June 26) An editorialist for the Chicago Sun-Times focused on changes that needed to be made by doctors and the medical community to help mothers-to-be. Believing that childbirth is miraculous should not mean denying it can be bad for a mother’s health—or lethal for the baby or children. What is needed is better tracking of depression. Hormonal research. And compassionate, educated treatment in wards specifically created for those suffering postpartum depression or psychosis. (Laney, 2001, July 25)


67 The Medical Frame was used by a St. Petersburg Times reporter in the aftermath of the suicide a local woman who suffered from PPD and disappeared. Doctors gave Gifford medication during her hospital stay last week, but some women need time—and perhaps different drugs—before they respond, Dresser said. Gifford would be at higher risk for depression because she had a Caesarian section, Dresser said. Some experts think an inability to deliver naturally contributes to feelings of inadequacy. (Davis, 2001, April 16) In a USA Today article giving general information about PPD, the Medical Frame also was evident. Women diagnosed with postpartum depression often have a history of depression or are suffering financial difficulties and trouble in their relationships, says Sanford, who wrote the book Postpartum Survival Guide. Few women with postpartum depression become psychotic, Sanford says. Many of those women have a history of untreated depression or psychosis. (Angle, 2001, June 22) The Society Frame The Society Frame covered a broad array of topics that did not fit under any of the other frames, but as a common denominator dealt with some aspect of social concerns. When the Society Frame was utilized, stories focused on the following general issues that related in some way to society at large or the local community: public opinion, economic consequences, cultural influences, societal expectations and norms, the class or status of Andrea Yates or women in similar circumstances, and the role of gender and/or feminism. Sometimes the Society Frame was used to compare and contrast cultural differences in prevention and treatment of PPD. One Chicago Sun-Times editorial said the following: In Hungary, if a new mother exhibits depression, she is hospitalized for 30 days while her hormone levels are regulated. Throughout Europe, the Edinburgh Postnatal Depression Scale is used. It gives a new mother a chance to discuss her feelings without feeling ashamed of them. It’s proven to be 95.5 percent specific in detecting major depression and, thus, treating it. Here, a new mother is sent home


68 in 24 to 48 hours, where she can quickly go from baby blues, to depression to psychosis. (Laney, 2001, July 25) In a similar vein, an American writer for The New York Times shared her experience after giving birth in Britain: The best part of having babies British-style was the aftercare. Every woman who gives birth in Britain, rich or poor, gets a house call by a midwife every day for at least 10 days. The midwives check on the mother’s recuperation and monitor the baby’s development. If midwives detect a medical problem in the baby or the mother, they can channel the woman into proper medical care. They are also on call 24 hours a day, every day. Besides the medical checks, the best part for me and most mothers I spoke with is the emotional support these visitors provide. (Epstein, 2001, December 4) The Society Frame also came into play when an article discussed the norms and expectations of society as a whole, or contrasted cultures, and how these affected PPD. For example, a writer for The New York Times noted, So why is it that despite 40 years of feminism and an overwhelming amount of evidence, we still refuse to release our notions of what motherhood means? Believing that childbirth is miraculous should not mean denying that it can be bad for a woman’s health—and lethal for the little one. In hunter-gatherer tribes like the Kung of the Kalahari Desert, estimates for infanticide are about one in 100 births. Hormones are a biological reality, but they intersect with culture at every point. Postpartum depression occurs less frequently in other regions, like China, Jamaica and some parts of Africa—where, not coincidentally, well-entrenched social rituals or government support cast a kind of protective balm over the raw days following birth. (Slater, 2001, July 8) An editorial from The New York Times looked at the economic consequences of society’s refusal to pay for mental illness treatment: But our willingness to pay to treat mental illness falls far short of our willingness to foot the bill to treat other diseases—or to shell out higher payments when people with mental illnesses wind up in hospital emergency rooms, jails, emergency welfare housing and courtrooms. Why the imbalance? Because employers, insurers and policymakers do not view psychiatric disorders as they do other medical conditions. So they refuse to invest in critical services. America pays a big price for this lack of equity. In 1999, a surgeon general’s report ranked mental illness as the second most costly in respect to impact on national productivity. Mental illness ranked only behind cardiovascular disease, but ahead of cancer and H.I.V./AIDS. (Stoltz, 2002, April 28)


69 Another New York Times editorialist commented about Andrea Yates’ class and how it affected public opinion: The essential point is that many middle-class Americans have been able to identify, and thus empathize, with Ms. Yates. She was a suburban middle-class woman struggling with mental illness and the enormous stress of raising five kids under the age of 8. Here was this white, middle-class woman who went off. But it wasn’t the act that proclaimed her craziness. It was also her status. The gut reactions throughout Texas and across the country would have been far different if Andrea Yates had been a crackhead, or a welfare mother, or some crazy guy with a gun who opened fire on classroom full of children. (Herbert, 2002, March 18) In addition to the Society Frame as a general category bringing together a wide variety of subjects discussing social factors, certain topics related to societal aspects came up with regularity throughout the articles analyzed, particularly in relation to PPD and the Andrea Yates case. These topics all still dealt with some aspect of society, yet came up more frequently throughout the newspapers than most of the other social subject matters, and followed several main themes. Rather than create several more frames that might dilute the overall view of the general relationship among these themes, the solution derived was to create subcategories that fell under the Society Frame. Thus, some stories fell under the following particular subcategories due to their focus on these more narrow aspects of the Society Frame: Publicity, Shame, and Support. Often, these frames intermingled with one or two other frames in a single story. All of these subcategories depend on or incorporate society to some extent. Publicity is based upon general public knowledge throughout society of certain individuals and events and their impact on society. Shame can be seen as a societal issue because it is based upon public condemnation of certain topics and circumstances. The concept of shame would not exist if there were no fear of other people’s knowledge of and reaction to specific events and issues. And the idea of Support is dependent by its very nature on society to various


70 extents. One or more people in society (whether it be family members or strangers) are required to provide assistance and support to someone. The Publicity category focused on the media coverage surrounding the Yates case or other notorious PPD or infanticide cases. Stories about celebrities who suffered PPD (e.g., Marie Osmond) or the effects of the widespread media coverage on Andrea Yates and/or local cases of mothers suffering PPD also fell under this subcategory. One example of how the Publicity subcategory was used comes from the Chicago Sun-Times, which noted in an article that Publicity about women suffering postpartum depression and psychosis who committed suicide has had one positive effect: Other women have learned help is available and are reaching out for it. (Rotzoll, 2001, July 20) Sometimes the actions of public figures such as politicians came up under the Publicity subcategory, as this Chicago Tribune article about a congressman’s efforts to create legislation dealing with PPD: U.S. Rep Bobby Rush (D-Ill.) said Tuesday that he will introduce a bill in Congress to provide more funding for the research and treatment of postpartum depression. At a news conference at Northwestern Memorial Hospital, Rush said the death last month of Melanie Stokes, 41, prompted him to introduce the bill. (“Rush starts,” 2001, July 4) Stories about the media coverage surrounding the Yates case also fell into the Publicity subcategory: Texas child-killer Andrea Yates has received an unexpected assist—from the “Today” show. Katie Couric told viewers on Monday how they could contribute to Yates defense fund—just days after Rosie O’Donnell told “Good Morning America” that she feels “overwhelming empathy” for Yates, who admits to drowning her five kids in the family bathtub in June. (Starr, 2001, August 15) Commentary on media coverage was another way that the Publicity subcategory of the Society Frame presented itself. In an editorial from The New York Times, one writer criticized what he saw as favorable coverage about Andrea Yates:


71 Suddenly the nation has a mass killer it can empathize with, identify with, care for, even love. So here’s Newsweek, in its cover story: “Most mass killers are sociopaths, utterly alienated from other human beings. They are callous or sadistic. Andrea was the opposite: if anything, she apparently cared too much.” The tone and approach of Newsweek’s coverage was typical. How could Andrea have done it? What could have possibly driven a nice middle-class suburban mother to drown her five children? (Herbert, 2001, July 5) An editorialist for The New York Times commented on the role of the media in such cases: “The media help us discern and interpret the personal and social forces that could have led to the horrifying tales of Mrs. Yates and Mr. Troy” (Stoltz, 2002, April 28). The subcategory of Shame was a frequently used aspect of the Society Frame, most often used by columnists who discussed the stigma surrounding PPD and the dangers of perpetuating a Hallmark Card version of motherhood as an underlying norm in American culture. Several newspapers framed PPD as a shameful mystery disease that rarely is discussed, either through the reporter’s or a stakeholder’s words. From a Chicago Tribune article: Postpartum depression is yet another form of mental illness that commonly goes undiagnosed. One reason is that, like other such illnesses, it’s a taboo subject to millions of Americans—hey, bet you’re happy about the new baby! It is also misunderstood and ignored by many mothers themselves. And it is often accompanied by extreme guilt and fear of social stigma when a woman feels indifferent—or worse—about the child she has just delivered. (“Postpartum risks,” 2001, June 15) The Chicago Tribune also used the phrases “mysterious world of postpartum disorders” and “often misunderstood condition” to describe PPD in another article (Deardorff & Hepp, 2001, June 12). A psychiatrist quoted in The Houston Chronicle noted that PPD is under-recognized, under-treated or missed altogether (Feldman, 2001, June 26). A St. Petersburg Times writer quoted a PPD advocate in an article that emphasized the stigma attached to PPD.


72 Society tells victims to “pull yourself together,” says Jane Honikman, founding director of Postpartum Support International, based in Santa Barbara, Calif. “The woman is stigmatized three ways. There’s a stigma because it’s about mental health, because it’s a woman and because it’s childbirth.” All are weighted with unrealistic expectations and prejudices, says Honikman. (Aschoff, 2001, April 18) One St. Petersburg Times columnist metaphorically described PPD as a “dark shroud that descends.” (Melone, 2001, April 22). Marie Osmond, who wrote a book about her struggle with PPD, was quoted as calling it “the darkest hole I’ve ever experienced” (Aschoff, 2001, April 18). Along with this stigma of shame, several newspapers pointed out that PPD is often seen as a weakness, rather than a mental illness. As a St. Petersburg Times writer reported, “People often expect the woman to just ‘snap out of it,’ Dresser said” (Davis, 2001, April 16). In addition, a Chicago Sun-Times editorial noted, The Supermom myth is still out there. Whether it’s the working mom who thinks she should bring home the bacon and fry it up in a pan or the full-time mom who thinks she should do it all exactly the way her mom did, women fear that asking for help will expose their weaknesses. (Richards, 2001, June 27) A childbirth assistant quoted in the St. Petersburg Times said that she wanted “the public to understand postpartum depression is an illness, not a character flaw” (Aschoff, 2001, April 18). The Chicago Tribune emphasized that “postpartum depression is an illness, not a failing,” and that PPP is “a very real disorder” (“Postpartum risks,” 2001, June 15; Deardorff & Hepp, 2001, June 12). The husband of Janet Gifford-Meyers, the Tampa Bay-area woman who committed suicide, alluded to this image of PPD: “I had heard of postpartum depression before, but I’d never realized it could be a serious condition,” said Steven Meyers, her husband. “People call it the baby blues, which makes it sound like this cutesy little thing women go through. It’s not.” (Davis, 2001, April 16)


73 This contrasted with the view described by writers in several of these newspapers that society perpetuates a myth of blissful and happy motherhood. An article from the Chicago Tribune highlighted this alleged myth: Given the images we see in ads and movies and on TV, why would Callahan or any other new mom not believe that a good mother could feel anything but joyful after the birth of a baby? After all, the message to new moms screams loudly: “This is the happiest time of your life.” (Sammons, 2001, October 21) One editorial for The New York Times observed: The flip side of this demonization of Mrs. Yates is the American sentimentalization of motherhood. It is seen as a sacred and sacrosanct sphere. The circle of mother and child is a Hallmark card place, where the selfless mother nurtures her young, no matter her dreams or ambitions, conflicts or terrors. Motherhood is seen through gauze, in soft, religiously inflected focus. Madonna and child. Through all that gauze, it’s hard to see a mother like Mrs. Yates as she really is—one of the desperate, destructive mothers nobody takes seriously until too late. (Fleming, 2002, March 17) Further on in the same editorial, she continued her discussion about societal expectations for mothers: There is always a chorus pushing and pulling at mothers, telling them how to do this or that, a lot of it from women themselves, as they try not to feel guilty about failing to live up to the myth. The advice, though often contradictory, can end up at the same place: reinforcing the myth of the all-important mother who should be able to meet all her children’s needs—physical, psychological, emotional and economic—without help or “interference” from anyone. Both the Chicago Tribune and St. Petersburg Times columnists referred to in the previous several paragraphs noted that media messages emphasize that the time after having a baby is supposed to be the happiest time of a woman’s life, a state of beatitude when she should be celebrating. The columnists observed that because of this idealistic and supposedly universal experience of motherhood, shame is reinforced when mothers don’t feel this way.


74 The Support subcategory typically was employed in discussion about the role of various entities, certain subsets of the community or society as a whole, and how they could or should be supporting new mothers. Their support and duties were either reiterated or found to be lacking in Andrea Yates’ and other PPD cases. These entities included the family, the medical system, friends, advocates, special interests, and the local community. The Support subcategory differed from the Blame Frame in that emphasis was placed on the interaction of various aspects of society with women suffering from PPD and explaining how communities and individuals could assist them, whereas the Blame Frame primarily looked to assign blame or responsibility for who failed Andrea Yates or other women with PPD. The Support subcategory typically framed matters in a positive light, while the Blame Frame tended to portray matters in a more negative way. Using advocates for sources was an example of the Support subcategory of the Society Frame. The advocates tended to focus on the need for the medical and local communities, as well as society as a whole to do more to help and support women with PPD. A Chicago Tribune article stated: Too often, women afflicted with postpartum depression do not receive adequate treatment or information because of a haphazard web of services for treating a disease that straddles two specialties, mental health and obstetrics, advocates say. (Mellen, 2001, June 27) Sometimes the Support subcategory was used simply to suggest ways for supporting new mothers, perhaps in copying other cultures’ methods. An example from an editorial for The New York Times said: Perhaps the solution to our lack of support for mothers and children will come from one of those other cultures, those pockets of relative maternal sanguineness. Perhaps we will offer longer maternity leave or programs to help fathers share in parental responsibility. (Slater, 2001, July 8)


75 The Support subcategory also came up in stories related to Andrea Yates, especially when special interest groups became involved in her case. The following came from The Houston Chronicle: The Houston Area National Organization for Women is rallying support for Andrea Pia Yates, the Clear Lake mother who has admitted to drowning her five children. In addition to forming the Andrea Pia Yates Support Coalition, the local chapter of NOW plans to help raise money for Yates’ defense fund, the organization’s state president said Thursday. (Teachey, 2001, August 24) The Storyteller Frame Due to the nature of the newspaper style of writing, which emphasizes telling the news within the framework of a story, the Storyteller Frame was the most basic and most frequently employed frame in general for all the newspapers when all the article topics are taken into account (as opposed to the Medical Frame being the dominant frame for articles that focused only on PPD). The Storyteller Frame was used to describe the facts of certain occurrences, as well as the actions and appearances of the people and/or entities involved. The Storyteller Frame was often employed to give a personal history or biography of certain individuals, especially those in high-profile cases, such as Andrea Yates, her husband Rusty, and other women who gained notoriety for their PPD cases. In some cases, several different styles of Storyteller Frames were used to write about the Andrea Yates or other PPD cases; in particular, in mystery/suspense, horror, or soap opera formats. Anything that made the story more personal was described and highlighted in this frame, especially emotions such as grief, sorrow, empathy, fear, and frustration. This frame most typically centered on the different figures involved, such as Andrea or Rusty Yates, or in other PPD cases, the woman who had disappeared, died, or killed her children. The personal life history of these people often was detailed, and


76 blow-by-blow accounts of events (such as the drownings of the Yates children) were given. Family, friends, and neighbors were the usual sources interviewed for this frame. The Storyteller Frame often began a story and set the tone for the rest of the article. This frame was used as the lead in an article from the Houston Chronicle telling the personal history of Andrea Yates: Andrea Pia Yates is now known around the world as the Texas woman who admitted to drowning her five children in her bathtub last week. But 19 years ago, she was little-known Andrea Kennedy—a quiet scholar-athlete who graduated second in her class at Milby High School and was captain of the swim team. (Warren, 2001, June 26) The Chicago Sun-Times recounted details of the drownings from Yates’ interview with the police: She said 7-year-old Noah walked into the bathroom and saw her holding the youngest child, 6-month-old Mary. “What’s wrong with Mary?” Noah asked his mother, according to the account. Yates told police she chased Noah through the house, dragged him back to the bathroom and drowned him next to Mary, the investigator told the newspaper. (Easton, 2001a, June 23) And a columnist for The New York Post used the Storyteller Frame to write her story in a murder mystery style: The murderer had grown cocky. Andrea Yates peeled back her lips. And she laughed. It was minutes before the jury’s verdict was announced in the case of the mother who drowned her five children in the family bathtub. (Peyser, 2002, March 13) Research Question 3: How Does Framing during and after the Andrea Yates Event Compare to Previous Framing of PPD? For this section, first the overall findings for all the newspapers will be presented, followed by frames that were used most frequently in each time period, in chronological order, with more detailed information about each individual newspaper. Framing of PPD before the Andrea Yates event was minimal to non-existent. Four of the newspapers basically did not cover the topic at all. The three newspapers that did (Chicago Sun


77 Times, Chicago Tribune, and St. Petersburg Times) covered the subject due to local-area women suffering from PPD who committed suicide. In those cases, the newspapers tended to portray the women sympathetically and mostly relied on the Storyteller Frame to tell their stories and the Medical Frame to give information about PPD. The most articles found to frame PPD appeared during the Andrea Yates event, with the Storyteller and Legal Frames most dominant. The Blame Frame was frequently used as well. In general, the newspapers used the Storyteller Frame to focus on Andrea Yates, the drownings and related reactions and occurrences, while the Legal Frame focused on the issues of the insanity plea and the death penalty, as well as trial testimony. The use of the Blame Frame ranged from condemnation of Andrea Yates and the need to punish her, disgust with her husband, and the responsibility of the medical and local community. This frame also included sympathy for Yates, which indicated a belief that she was not to blame for her actions due to her mental illness and that other factors were responsible. Framing of PPD after the Andrea Yates trial ended dropped almost entirely back to the pre-Andrea Yates level, with the newspapers again giving little attention to this issue. Most of the articles during this time were published shortly after the trial and relied mostly on the Blame Frame. These articles were concerned mostly with placing blame on the persons or institutions the writer deemed responsible for Andrea’s actions. Framing before the Andrea Yates Event The time frame covered before the Andrea Yates’ event began June 21, 2000 and ended June 20, 2001. A total of 22 articles were found to refer to PPD before Andrea Yates drowned her children, the fewest number of articles for the three time periods discussed for this research question. The Storyteller and Medical Frames were used most


78 frequently (13 and 14 times, respectively). The Society Frame also was used about half the time (10 times). In general, the focus of these articles and frames were about another related subject matter, rather than explicitly about PPD. In fact, little was written about PPD except as a brief mention included in an article about another topic, such as Marie Osmond’s personal struggle with the condition or information for new dads adjusting to having a baby in the family. During this time period, however, news that was PPD-related most often was tied into a local missing mom case. This was especially the case for the Chicago Sun-Times, the Chicago Tribune, and the St. Petersburg Times. The Chicago newspapers covered Melanie Stokes, a woman suffering from PPP who committed suicide, and a mother of quadruplets who drowned herself shortly after giving birth, and the St. Petersburg Times covered Janet Gifford-Meyers, a new mother with PPD who also committed suicide. The three articles published by the Chicago Sun-Times during this time focused primarily around Melanie Stokes’ disappearance and used the Storyteller and Medical Frames. Some information about PPP was given also. They mostly described in a sympathetic manner what happened to Melanie Stokes and how PPD caused her actions. Most of the seven Chicago Tribune articles focused on the Melanie Stokes event. These articles made the most use of the Storyteller and Medical Frames, giving information about Melanie Stokes’ background and actions, as well as about PPD. Information was also given about new fathers and the stresses they face, especially if the mother is depressed after childbirth, which used the Society Frame (under the Support subcategory).


79 The Houston Chronicle, The New York Post, The New York Times and USA Today essentially did not cover the subject often. Three of these newspapers only published one or two articles that were PPD-related and no articles were found for USA Today during this time frame that fit the study’s criteria. None of them specifically discussed PPD and only mentioned it in relation to the main topic of the story, such as when information about Marie Osmond’s book about her personal experience with PPD was publicized or in a story about a Bronx woman who suffocated her child; PPD was noted as a possible cause of her behavior. In the eight articles found in the St. Petersburg Times, PPD mostly was framed in the Storyteller Frame (based around the Janet Gifford-Meyers event) and typically in a sympathetic manner toward her. The Jekyll and Hyde Frame was found in about half of the articles, which focused on the Jekyll aspect of the frame, that Gifford-Meyers was not in the right frame of mind. The issue of shame (a subcategory of the Society Frame) was highlighted, with reference to the social stigma of PPD and the unrealistic “Super Mom” expectations placed on mothers by societal pressure. Framing during the Andrea Yates Event This section covers articles about PPD that were published from the time of the initial breaking news about Andrea Yates drowning her children and throughout her competency hearing and trial. These articles were analyzed for the most frequently used frames. This time period spanned from June 21, 2001 to March 16, 2002. Although articles concerning PPD and the Andrea Yates event were published throughout this entire time span, the majority of them grouped into two main stages: June 21 through early September and early January through mid-March. The first grouping reflected the initial onset of the event (particularly in late June and throughout July) until the original


80 date of Yates’ hearing to determine her competency to stand trial, which was on September 11. The hearing was delayed by the September 11 terrorist attacks that also consumed most news coverage from that time forward until the trial began in January. The second grouping occurred from the beginning to the end of Yates’ trial, which was completed in March. The greatest number of articles related to PPD was published during this time interval, for a total of 205 articles. By far, the Storyteller Frame was the most dominant across all the newspapers (118 times). The Legal Frame was used nearly as often (97 times). The Jekyll and Hyde Frame was used the least (23 times). Most of the newspapers generally followed this framing pattern (Chicago Sun-Times, Chicago Tribune, The Houston Chronicle, St. Petersburg Times, and The New York Times), although in two of these cases (The Houston Chronicle and The New York Times) the use of the Legal and Storyteller Frames was approximately the same. The New York Post, however, differed from this overall pattern. While the Storyteller Frame was still the most often used, the Blame Frame was utilized almost as much, rather than the Legal Frame. Notably, the Medical Frame did not occur at all. USA Today also varied from the general pattern of frames used. The Legal Frame was employed most frequently. The Storyteller and Blame Frames were the next most used, with equivalent use to each other. Framing after the Andrea Yates Event This section discusses the most frequently used frames and number of articles for the time period following the end of Andrea Yates’ trial. The trial ended on March 15, 2002. Because almost all of the newspapers published an article the following day, March 16, giving news about the final verdict of the trial, that day was considered to be


81 part of the Andrea Yates event, and March 17th began the time period after the entire event was over. This time period ended on June 21, 2002. Twenty-nine articles that framed PPD and related issues were found for this time period. In general, most of these articles were published in March and April, just after the trial ended. Many of them were editorials or commentaries written in reaction to the end of the trial and the entire scope of Andrea Yates’ case. The main exception to this pattern was The Houston Chronicle. All of its articles found after the trial coverage were published in June in the several days surrounding the anniversary date of the Yates children’s drownings. The Chicago Tribune also published one article on June 21st as well. The Blame Frame was used most often among the newspapers during this time. The Legal, Society, and Storyteller Frames also were used frequently and equally to each other. The Battle Frame was used the least. The Blame Frame was predominant in some form in all four articles from the Chicago Sun-Times. This included criticisms by Rusty Yates and Andrea Yates’ family over responsibility for allowing her to reach the point that she did and criticism for use of the insanity plea, as well as an opinion column suggesting Yates reached her goal of liberating herself from her responsibilities. Legal investigation into opening a case on Rusty Yates’ possible responsibility was another use of the Blame Frame, in addition to the Legal Frame. The Storyteller and Battle Frames were used in describing Yates’ husband’s and family’s reactions after the case was over. The seven Chicago Tribune articles applied the Legal Frames and/or the Blame Frame equivalently in discussions of the aftermath of the Andrea Yates trial. Several of the Houston Chronicle articles employed the Legal Frame also, revolving around follow


82 up stories to the Yates trial. The Society Frame was used in several articles as well, mostly in the Publicity and Support categories (one detailed a fund set up in Andrea Yates’ honor to promote PPD education and support and the other described the release of tapes of interviews with Andrea Yates while she was in prison). The Blame Frame was used in all but one of The New York Post’s articles. These articles mostly focused on Rusty Yates’ responsibility for Yates’ behavior. On the other hand, the St. Petersburg Times and USA Today essentially stopped coverage of PPD after Andrea Yates’ trial. The minimal coverage available made extensive use of the Blame and Storyteller Frames in discussing Yates’ case, mental illness, and societal responsibility and judgment. Andrea Yates and women in similar situations were portrayed sympathetically, thus implying blame on other people and institutions, including Rusty Yates, Yates’ last treating psychiatrist before the drownings, and society at large. Research Question 4: Did National Newspaper Coverage Differ from Local Coverage of the Andrea Yates Case? National newspaper coverage of the Andrea Yates case did differ from local coverage of the case. The main difference observed between national or elite newspaper coverage versus local or non-elite newspaper coverage was that the local newspapers had higher coverage of the Andrea Yates case than the national newspapers, with the exception of the St. Petersburg Times, which, as noted earlier, carried very few full articles covering the Andrea Yates case due to its The Nation in Brief updates. See Tables 4-4 and 4-5 for the breakdown of newspaper article topics covered by the national and local newspapers.


83 Table 4-4. Main topics of national (elite) newspaper articles. Newspapers Andrea Yates Local/other PPD cases PPD/PPP Maternal filicide Other CT 29 13 10 3 4 NYT 23 2 1 0 3 USAT 17 0 1 0 0 Table 4-5. Main topics of local (non-elite) newspaper articles. Newspapers Andrea Yates Local/other PPD cases PPD/PPP Maternal filicide Other CS-T 33 7 9 0 0 HC 49 2 2 1 0 NYP 31 2 0 0 1 SPT 4 6 2 0 0 Another noticeable difference was between the Chicago Tribune and the other national newspapers. Not only did the Chicago Tribune carry more articles about the Andrea Yates case, it published significantly more articles about PPD and local cases of women suffering PPD who gained notoriety for killing themselves. It was also the only elite newspaper to discuss maternal filicide in several articles. A striking difference was shown in the sheer number of articles produced by The Houston Chronicle newspaper in comparison to most of the other newspapers, both national and local. The Houston Chronicle published almost twice as many articles about or related to the Andrea Yates case (in two cases even more than double) than the other newspapers. Although approximately the same number of articles from each Chicago newspaper was analyzed for this study as from The Houston Chronicle, when stories about Chicago-area cases of PPD, as well as about PPD itself, are removed, the number of stories with Andrea Yates as the main topic drops to nearly half as many as were published by The Houston Chronicle, similar to the amounts for The New York Post and The New York Times. USA Today and the St. Petersburg Times had significantly fewer


84 articles about Andrea Yates than the other newspapers; however, all but one of the USA Today articles focused on the Andrea Yates case. Interestingly, only two of The Houston Chronicle’s articles focused exclusively on PPD, whereas the Chicago Sun-Times produced nine articles focusing on this topic, and the Chicago Tribune published 10 articles. The other newspapers only published one or two articles about PPD, except for The New York Post, which did not publish any articles with PPD as the main topic at all. Another conspicuous difference was in the tone of the articles published by The New York Post, compared to the other newspapers. Many of the articles written for The New York Post put forth the view that Andrea Yates should be held accountable for her actions, whereas the other newspapers tended to be more neutral or supportive of her in general. One manner in which The New York Post showed this tone was by its headlines. The headlines used for most of The New York Post’s articles leaned toward a more sensationalistic and tabloid style than the other newspapers. Some examples of this newspaper’s headlines follow: “Killer Mom Bombshell; Tried 2nd [sic] Suicide Just Months Before Drownings” (Lehman, 2001, June 29) “Killer Mom: ‘Devil’s in Me’” (Geller, 2001, July 1) “Jury to be Selected in Tub-Tots Slay” (2002, January 7) “’Devil’ Drove Mom to Murder” (Hunter, 2002, January 31) “Kill? She Just Interrupted 5 Tiny Lives” (Peyser, 2002, February 19) “Killer Mom Drowned Kids to ‘Save’ Them from Satan” (Long & Hunter, 2002, March 6) “Justice has Last Laugh on Despicable Murderer” (Peyser, 2002, March 13) “Hubby Slams Med Bureaucracy” (Long & Geller, 2002, March 16) “There was a Second Psycho in that Household” (Peyser, 2002, March 16)


85 In contrast, the other newspapers in the majority of their headlines referred to the Yates event as deaths, drownings, or slayings, not murders or killings, and to Yates’ actions that day with “drowned” or “killed.” None of them referred to Yates as a “Killer Mom.” Examples of such headlines from the other newspapers include: “Dad says depression was fatal; Vows to support wife accused of killing their kids” (Chicago Sun-Times) (Lehman, 2001, June 22) “’Zombie-like’ mom details drowning of her 5 children” (Chicago Tribune) (Easton, 2001b, June 23) “Mom of 5 [sic]: ‘I killed my kids’; Children may have died in tub” (The Houston Chronicle) (Glenn et al, 2001, June 21) “Death Penalty Sought for Mother in Drownings of Children” (The New York Times) (Yardley, 2001, August 9) “Drownings are tragedy, not politics” (St. Petersburg Times) (Fritz, 2001, September 10) “Mom’s sanity focus of drowning trial; Texas woman faces death in 5 kids’ slayings” (USA Today) (2002, January 4) Another difference from The New York Post was that some headlines of the other newspapers seemed to portray a sympathetic attitude toward Andrea Yates. “Doctors need to help depressed mothers” (Chicago Sun-Times) (Laney, 2001, July 25) “Yates should not face death penalty for child drownings” (Chicago Tribune) (Parker, 2001, August 15) “Sending out the wrong message on mental illness” (Chicago Tribune) (Krauthammer, 2002, March 18)6 “A life unraveled/ [sic] Mom depicted as private, caring, burdened by hidden problems” (The Houston Chronicle) (Bernstein & Garcia, 2001, June 24) 6 Charles Krauthammer is a nationally syndicated columnist. This column also was found among the articles for The Houston Chronicle. A few other instances of the same story appearing in more than one of the newspapers analyzed here occurred, usually when a story from the Associated Press was picked up or a columnist was syndicated nationwide.


86 “Despair plagued mother held in children’s deaths” (The New York Times) (Yardley, 2001, September 8) “Unjust rules for insanity” (The New York Times) (Bard, 2002, March 13) “Abandoned by sanity, victimized by ignorance” (St. Petersburg Times) (Melone, 2002, March 17) Opinion columns or editorials demonstrated the most unsympathetic stance toward Andrea Yates. Ten columns were included among The New York Post’s stories analyzed for this study, more than were found for the other newspapers. Nine of these columnists were very adamant about Yates’ guilt and felt she needed to be punished. The one other columnist’s view on Yates’ guilt was not made clear but she decried the American acceptance of the death penalty. The Chicago Sun-Times was the only other newspaper to publish more unsympathetic columns or editorials than sympathetic ones toward Andrea Yates. Four of the seven columns focused on Yates’ guilt, while two were sympathetic to her mental illness. One columnist did not either seem to blame or exonerate Yates but focused on society’s responsibility in such cases. The one column found for USA Today was unsympathetic toward Andrea Yates also. In contrast, all seven of the Chicago Tribune columns were sympathetic toward Andrea Yates. The St Petersburg Times had three columns, two of which were sympathetic (one for Andrea Yates, one for Janet Gifford-Myers) and one that was neutral in its stance. The New York Times had seven columns, with three of the columnists sympathetic (one toward Rusty), one who was unsympathetic, and four who were neutral or whose stance on Yates’ guilt was not clear (e.g., one was opposed to the death penalty but felt Yates was able to avoid it because of her class and race status).


87 Another difference among the newspapers was that the Chicago Tribune discussed maternal filicide in several articles whereas none of the other newspapers but The Houston Chronicle covered that topic. The Houston Chronicle published one article about maternal filicide. The Chicago Tribune published an article about child abuse and the possible link of PPD in some cases, which was listed in the “Other” category. No other newspaper covered this topic.


CHAPTER 5 DISCUSSION The Andrea Yates case brought the issue of PPD to the American public’s attention in a jarring way that was rarely, if ever, seen before. Her case may have set a precedent for future legal cases dealing with PPD in determining the viability of using the insanity plea or seeking the death penalty. In addition, her case and other PPD-related cases possibly may instigate public policy changes to assist women afflicted with this condition. For example, the United States House Representative from Illinois at the time, Bobby Rush, introduced a bill in Congress to provide more funding for the research and treatment of PPD a month after Melanie Stokes died in Chicago (“Rush starts,” 2001). Further, Yates’ case accentuated the roles and responsibilities of family, friends, communities, medical practitioners, and public health policymakers in being aware of, diagnosing, preventing, and treating future cases of PPD. Perhaps more significantly, the importance of the media’s role as information provider and agenda-setter for the general public was heightened greatly. The sudden surge in publicity generated by this case and the media’s close interest in the topic offered an exceptional opportunity to examine more closely newspaper framing of PPD. The findings from this study show that newspapers indeed did frame PPD in specific ways, using certain words, phrases and sources to highlight or exclude different aspects of Andrea Yates’ and other women’s cases. It also showed that these frames changed and shifted over time, depending on what features of the PPD issue the newspaper chose to emphasize. While these frames may have been helpful in simplifying 88


89 the multifaceted issue of PPD for the general newspaper-reading public, the main audience for these articles, the frames also may have left the readers with a narrow and incomplete understanding of this topic. Readers may have been confounded further because of the extreme fluctuation in newspaper coverage and the constant change of frame dominance throughout the time period analyzed (e.g., the prevalence of the Medical Frame early on to explain PPD and PPP, then later recurrent use of the Legal Frame as emphasis shifted to the trial). This continual shifting in what newspapers deemed important to cover ultimately may have left readers perplexed as to what they needed to know about PPD and doubtful of its significance to their lives and those around them. Furthermore, newspaper coverage surrounding the Andrea Yates event and PPD provoked strong reactions by the public (which may have been amplified by this confusion), as noted by columnists and editorialists as well as various quoted sources (such as police spokesmen or lawyers involved in the Andrea Yates case) who commented on the feedback they had received from the public via emails, phone calls, and letters. These reactions covered a wide range from sympathy for the mother and questioning of the shame and stigma surrounding PPD to harsh judgment of her behavior and reinforcement of existing myths, stereotypes, and prejudices. The first question in this study sought to determine how newspapers and stakeholders explicitly defined and explained PPD. It was found that the newspapers as a whole made little effort to define PPD and that the information given often was incomplete, conflicting, and occasionally inaccurate. Based on this finding, the average reader of a newspaper may come away with a limited understanding about the issue of PPD, or could be confused altogether by the inconsistencies in the information given.

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90 The reader may not understand that there are several levels of severity of this condition or the range of causes, symptoms, and treatments that accompany it. In addition, the reader may never have the opportunity to get a full explanation of PPD from newspapers because coverage of this issue was minimal before the Andrea Yates event, quickly dropped after her trial was over, and appeared to increase only when a local case of an extreme nature occurred and was publicized. Looking more closely at how stakeholders defined PPD, the reliance of newspapers on medical experts, particularly specialists in OB-GYN and mental health, led to a prevailing focus on the role of hormones in triggering PPD and other possible biological causes. This may influence newspaper readers to believe that this is simply a medical condition that can be treated easily with anti-depressants, without understanding the role of other factors in the development of PPD, such as a lack of spousal or familial support, or the importance of counseling and support groups in its treatment. The emphasis by legal experts on the insanity plea and the death penalty aspects of the Yates’ case may have overshadowed the possibility of other legal options so much so that the reader may not consider or realize there could be other legal methods of dealing with similar cases. For instance, some states offer alternative legal sentences such as “guilty except for insanity” or “guilty but mentally ill.” In Oregon, defendants given this sentence must get treatment and are placed under the jurisdiction of a state board (which includes two mental-health experts) for the same period they would have served in prison. This ensures that violent offenders are supervised for periods commensurate with their crime. Connecticut and Maryland also have similarly protective laws (“Texas law,” 2002, March 12) . The rather limited coverage of special interest groups such as ACLU, NOW, and the

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91 Independent Women’s Action Project (IWAP) regarding PPD may lead readers to believe that their views and definitions of PPD are on the alternative fringe (regardless of whether these groups actually are on the fringe or promote more mainstream views) and thus, easily ignored. The second research question looked at how the newspapers in this study framed PPD in the context of the Andrea Yates case. Journalists look to a set of commonly accepted news values to help them determine the newsworthiness of events (Mencher, 2000) , which can lead to framing events in a certain way so as to create a story that is considered newsworthy. These values include: Timeliness Impact, consequence, or importance Prominence of the people involved Proximity to readers and listeners Conflict The unusual nature of the event Currency, the sudden interest people have in an ongoing situation Andrea Yates’ drowning of her five children fits well under Birkland’s (1998) definition of focusing events as sudden, relatively uncommon, and reasonably defined as harmful, as noted in the introduction to this study. The subsequent newspaper coverage that ensued also follows the pattern noted by mass communication researchers of a focusing event concentrating attention on an issue (in this case, PPD) that was dormant and previously given scant notice, as this study found. In addition, this event met almost all the requirements of the news values listed above to qualify as newsworthy. Thus, the framing of PPD by the newspapers using these news values may have significantly affected the attention paid and importance ascribed to this issue by the public.

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92 Generally, the story trumped the issue, as may be expected in the journalism field, due to the necessity to grab reader interest. In looking for a way to make PPD an interesting topic to the general public, the frames used by the journalists tended to oversimplify the issue or only highlight certain aspects of it. Thus, the public may have become aware of only certain narrow aspects of the PPD issue depending on how it was framed (e.g., related legal issues, individual women’s personal struggles with PPD, or the blame placed on various entities for not preventing or treating Andrea Yates’ PPD). The study revealed seven major frames that the newspapers used in their articles. The Storyteller Frame was the most frequently used frame for all the newspapers throughout the entire time period studied, reflecting the journalism norm of reporting information in a story form. This may indicate that the media do not believe the public is likely to pay attention to a certain issue unless it is attached to a story with a personal human interest factor to which people can relate. The common use of the Battle Frame, especially during the trial, also fits with the newspaper-reporting norm that controversy and conflict are essential to capture and retain interest in a story, especially when it involves a complex problem like PPD. A trial offers an inherently conflicting situation, but the newspapers also used this frame to create a sense of conflict in other situations as well, such as pitting societal opinion against Rusty Yates or setting the feminist groups supporting Andrea Yates against those who believed she needed to be punished for her deeds. Using the Battle Frame simplified this complicated issue into more of a black-and-white matter and made it easier to understand for the general public (among which a typical comprehension level for reading newspapers usually is attributed to be about the eighth-grade level).

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93 This is also the case for the Legal Frame, which usually broke down complex legal topics into more simple matters of two opposing sides attempting to put forth their views on a situation to muster support for their cause. In addition, the Legal Frame often was used to tell day-to-day happenings during the trial, which lends itself more readily to a narrative form and thus makes this frame one that newspapers were more likely to use. These efforts to simplify a complicated case for the general public may be the reason the Blame Frame was used often as well, especially during and after the Andrea Yates event. Reducing the range of concerns related to PPD and Yates’ case to merely who or what was responsible likely may have been seen as making the stories more interesting to the news-reading public and easier for them to understand. The popularity of the Jekyll and Hyde Frame also may be yet another effort at subjugating into a simple either/or viewpoint the ever-controversial matter of the proper role and image of women, especially in this era of constantly shifting gender attitudes and beliefs in Western cultures. And despite the actual commonality of infanticide throughout the ages and in other countries today, especially in the Third World, citizens of present-day Western societies—which as a whole usually are considered to be far more wealthy and educated than any other society at any point in time—are shocked when such instances are brought to public attention. In an effort to understand how infanticide can continue to occur in modern times, it seems necessary for many people to break its complex causes down to a simple matter of evil versus good. Meyer and Oberman (2001, p.17) noted that most contemporary societies treat infanticide either as a manifestation of illness or as a manifestation of evil. This is reinforced when mental

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94 health issues such as PPD are brought into the picture, due to the stigma, shame, and general misunderstanding surrounding these issues. Interestingly, one of the most common phrases that cropped up continually throughout these articles when describing how PPD overtook these women was that they “spiraled down into PPD.” It was even described as a descent into madness once or twice. This could imply a connotation of hell with PPD and mental illness. This association with the devil, in a specific sense, and evil, in a more general sense, is perhaps a big part of the reason this issue has such a stigma attached to it. This may in part account for why the Jekyll and Hyde Frame was used so readily. The fact that the Medical Frame was the most prevalent frame used in the definitions of PPD specifically (as opposed to the use of the Storyteller Frame across all newspapers in general for Andrea Yates and all other article topics), reinforces the finding by Martinez et al. (2000) that the medical model of postpartum affective disturbances such as PPD is the foremost one used by physicians and also indicates that, when confronted with the need to explain a health issue—even a mental health issue—reporters generally turn to the medical community rather than psychologists or other mental health experts. The reliance by the newspaper’s reporters on physicians as expert sources about PPD led to this view being the most propagated throughout the newspapers, especially right after Yates drowned her children. However, support for the stress and coping model described by Martinez et al. (2000) also was found in many of the articles analyzed for this study, mostly in connection with use of the Society Frame, although some physicians stressed the interaction of social or cultural causes with medical ones. Use of the feminist model was

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95 found in the Society Frame as well. However, limited coverage was given to feminist advocates in comparison to physicians and social scientists, and an element of controversy often was included with portrayals of NOW and feminist advocates in these articles (such as writing about the actions or comments by groups opposed to Andrea Yates’ support in the same stories). This indicates that by the use of framing, the newspapers indicated who the most important sources were and which views were considered to be the most prominent and accepted. While the Society Frame was used extensively, especially in articles that discussed the role of various societal aspects in causing PPD or how different institutions in society should be responding to this issue, the broadness of this category made it difficult to determine its possible influence on the public. However, the attention given to the publicity of the Andrea Yates case may reinforce the importance the media places on itself in its role and influence on the public. In addition, the reiteration of the shame and stigma associated with PPD, as well as the underlying societal norm of the postpartum period being a time of joyfulness and fulfillment for women, actually may have served to reinforce these views, despite the writers’ attempts to bring these matters to light in order to discredit them. The third question in this study compared framing of PPD before the Andrea Yates event to framing during and after the focusing event. The finding that coverage of PPD before the Andrea Yates event was minimal, spiked after the drownings and throughout the trial, and then dropped again after the trial was over suggests that it took a dramatic episode such as the childrens’ drownings to capture public interest (or at least journalists’ interest) for the PPD issue. Once the public’s attention was not drawn to the issue after

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96 the end of Andrea Yates’ trial, the newspapers quickly reduced coverage. It may indicate that the newspapers’ gatekeepers felt the public no longer would be interested in coverage about PPD when there was no longer a sensational story with which to link it. The prevalence of the Storyteller Frame both before and during the Andrea Yates event demonstrated the importance the newspapers placed on using stories to trigger and maintain public interest in the PPD issue. It also showed the need for the general public to have a story and people they could identify with to help them understand and place in perspective such a complicated matter as PPD. The Medical Frame also was dominant in articles about PPD before the Andrea Yates event. Most likely this occurred because there were so few articles about PPD during this time frame; thus the ones that were published often focused exclusively on PPD itself and medical experts were used to give information about it. Similarly, when local cases of suicide or infanticide by women suffering from PPD became headline news, medical experts were used as sources for explaining PPD’s effects on these women. The switch to increased usage of the Legal Frame during the Yates event points to the heavy emphasis on trial coverage, which inherently carries the elements of drama that newspapers rely on to maintain public interest. The later emergence of the Blame Frame as the most frequently used frame after the trial was finished may reflect a tendency by the general public to examine closely the causes and consequences of a significant eve nt once it is over in order to determine where responsibility lies so as to better understand what happened and prevent future recurrences. The final question investigated the differences between national and local coverage of the Andrea Yates case. One main finding was that The Houston Chronicle had more

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97 coverage about the Andrea Yates event than any of the other newspapers. This is to be expected, considering it is the newspaper for Yates’ hometown. However, it is surprising that despite all this coverage about Andrea Yates, only two articles from this newspaper focused solely on PPD. A few articles in the initial weeks after the drownings included some PPD information as part of stories focusing on other aspects of Yates’ case, but this low number still is puzzling and disheartening. The most likely conclusion that can be drawn is that the editors and other gatekeepers at The Houston Chronicle felt these articles sufficiently covered the topic and that the public knew enough to understand PPD after that, and that any more such articles would be overkill. While it is somewhat surprising that the Chicago newspapers published more articles directly about PPD than the Houston newspaper, it makes sense when the deaths of four women in the Chicago metropolitan area suffering from PPD or PPP within the span of a few months are taken into account. It appears that location of the newspaper played some role in amount of coverage of the Andrea Yates case and PPD, if not a very significant one. The Chicago newspapers had the most coverage of both Andrea Yates and PPD after The Houston Chronicle1. The Chicago Sun-Times had the second-highest amount of articles about Andrea Yates and PPD. Although The New York Post had two more articles about Andrea Yates than the Chicago Tribune, it had none about PPD, while the Tribune had the most articles directly about PPD. While this was probably due in part to the increase in publicity about this topic given the notoriety of recent local cases, it is possible that 1 Refer to Tables 4-4 and 4-5 for numerical data about article topics.

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98 because Chicago is a midwestern city, closer to the Southwest than the other newspapers, its closer proximity also may account for the greater number of articles. The newspapers considered the most national in scope, The New York Times (which is considered the elite leader for all other U.S. newspapers) and USA Today, did not allocate as many articles to the Andrea Yates event or PPD as the Chicago or Houston papers. Again, this appears logical, given the wide scope of coverage by these papers. In fact, the large amount of coverage given (especially by The New York Times) could be considered especially significant for the importance of this event, especially when the extensive coverage about the September 11 terrorist attacks during this time period is taken into account. Perhaps the most perplexing angle to this part of the study is the lack of attention paid to the Andrea Yates case by the St. Petersburg Times, especially in light of the extensive coverage given to the local PPD case of Janet Gifford-Meyers. This can be largely explained by that fact that, as noted earlier, many articles that did cover Andrea Yates were discarded because they were briefs that did not qualify for content analysis under the terms laid out in the methodology section. Another possibility for this dearth of coverage may be that, due to the amount of news coverage of the Gifford-Meyers’ case, the newspaper’s gatekeepers decided the local public was burned out on the topic of PPD and decided to limit coverage on this topic. However, this contradicts what happened with the Chicago newspapers, which covered the Andrea Yates trial extensively despite having at least several local cases that garnered widespread media coverage during the same time span. Given the St. Petersburg Times’ status as a newspaper widely considered to be one of the best in the nation, partly due to its independent ownership as

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99 compared to the corporate ownership of most other newspapers, it still is somewhat startling that more full-length articles weren’t devoted to her case. But possibly this independent status among newspapers is the reason why the St. Petersburg Times rejected more frequent and detailed coverage about Andrea Yates; it was not beholden to a corporate entity to produce news that was considered most desired by the public. At any rate, any future research on this topic involving the St. Petersburg Times might do well to consider alternate means of selecting articles for analysis to determine if the method of selection was the reason for this difference. The study also explored the overall tone or attitude of the newspaper in regard to the Andrea Yates case and PPD. The differences among the newspapers’ tone of reporting was minimal, with the notable exception of The New York Post. While the other newspapers appeared to take a neutral tone in their reporting of the Andrea Yates’ case, and in a few cases, leaned toward a more sympathetic view (most notably the Chicago Tribune), the Post was the only newspaper regularly to use a sensationalistic style of reporting and a strongly negative view of Andrea Yates and her culpability. This is not very unexpected, however, because The New York Post is considered more of a tabloid than the other newspapers studied. In fact, it is widely accepted that The New York Post produces sensationalized and opinionated coverage of virtually any issue it covers. Elite media such as the Chicago Tribune, The New York Times, and USA Today attempt to apply a more objective style of reporting that strives to show all sides of an issue, as deemed desirable by journalistic norms. These newspapers also are more likely to be read by the sector of the populace that has received a college-level or post-graduate education. A tabloid newspaper, on the other hand, is designed to be read by—and

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100 appeal to—a less educated sector of the public. Thus, a population with a wider range of education levels is likely to read a paper such as The New York Post. In order to obtain interest by as many of their readers as possible, The New York Post may have been more likely than the elite newspapers to reduce complex issues to simpler black-or-white terms. This, in turn, may have created a seemingly more judgmental view. However, another possibility to be considered for why The New York Post seemed less forgiving in its tone may be because more opinion columns were retrieved from this newspaper than any of the others. This may simply reflect the inclination of more of the Post’s columnists’ desire to address this topic than columnists for the other newspapers. However, the retrieval method of gathering newspaper articles for this study may have affected this finding, and a different method that attained approximately the same number of columns for each newspaper that addressed the Andrea Yates or PPD topic might lead to a different conclusion. Practical Implications of This Study This study adds to the scholarly literature for mass communication researchers by reinforcing the significance of framing theory and focusing events in understanding the mass media and how it shapes public opinion. Those in the medical field can seek ways to work with journalists to best convey more effectively correct and comprehensive information about PPD. People in the health education field can glean ideas from this study on better ways to get out information about PPD to the public, as well as learn what works and doesn’t work to draw public attention to various health issues. And perhaps most importantly, journalists can learn the importance of giving accurate, complete and consistent information in their stories about intricate health issues like PPD—otherwise, they possibly could fuel misunderstandings by the general public.

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101 It is interesting to note who was not quoted by the newspapers in this study, indicating which viewpoints perhaps were deemed of lesser importance on the PPD issue. People who largely were not sought out for their opinions and/or expertise yet who may be impacted greatly by this issue or influential in affecting changes include: Health insurance experts Hospital administrators Doctors outside the OB-GYN and mental health specialties (particularly general practitioners and pediatricians who come in regular contact with these mothers) Medical students and residents (who could give an honest assessment about their training to detect PPD) Midwives and alternative birth experts Social workers who work with high-risk families, especially for neglect or abuse Single mothers (who can be most affected by lack of family support) PPD experts from other countries Local and federal government health policymakers and legislators Economic experts (who can note the economic costs of PPD to society) Additionally, there was little to no emphasis on the point of view of the Yates children or other children harmed or killed by mothers suffering from PPD. Although there were victims’ rights groups speaking out for Andrea Yates, there appeared to be no support group for the children. In a sense, columnists for The New York Post and the other newspapers who continually reminded the news-reading public of the fact that Andrea Yates had killed her own children and emphasized their innocence and unrealized lives were the main voice for these children. A final implication of this study is to note what frames were missing from the newspaper coverage observed in this study. Economic consequences were mostly overlooked, such as the possible increased costs to the health insurance industry, hospitals, and the local community to boost screening and prevention efforts, intervention, and support services to women with PPD. On the flip side, the papers mostly ignored the financial and intangible costs to society of not doing more to assist

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102 these women. This includes the role of the health insurance industry in possibly curtailing or denying coverage for PPD treatment, which can limit efforts to keep at-risk mothers in hospital or mental facilities longer than the typical one or two days allotted for recovery from childbirth. Although the role the health insurance industry may have played in Andrea Yates’ case is uncertain and the responsibility it bears for any worsening of her condition due to discontinuation of treatment is debatable, Rusty Yates blamed his health insurance provider for failing him and advised others to pay any bills for mental illness rather than go to an HMO or preferred provider (Parker, 2002, March 18) . In addition, a writer for The New York Times noted that society’s willingness to pay to treat mental illness falls far short of its willingness to foot the bill to treat other diseases and claimed that private and public insurers largely bore responsibility for this lack of parity because employers, insurers, and policymakers do not view psychiatric disorders as they do other medical conditions (Stoltz, 2002, April 28). Given these points of view, it is interesting that so little attention was given to the possible role of health insurance in Yates’ and other PPD cases, or to using health insurance experts as sources in their articles by the newspapers. Other effects on society include possible higher rates of infanticide, neglected and/or abused children by mothers who don’t get help, as well as the delayed return of these women to the workplace and the subsequent financial impact on the economy. Limitations of This Study One potential limitation in this study was that despite going through the search process for each newspaper several times, relying on electronic databases, particularly the LexisNexis Academic database, appeared to retrieve columns and editorials inconsistently. For example, one columnist on a newspaper’s staff made a specific

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103 reference to an earlier column she had written about Andrea Yates and noted she would continue to write about her until the case was over, yet that was the only one of her columns that was retrieved for that newspaper. For some newspapers the database retrieved quite a few columns and hard news stories, while others had only a few. It is difficult to determine if this was because fewer columns were written about Andrea Yates or PPD in certain newspapers or if some columns just were not retrieved because of the search terms used. The only way to resolve this difficulty would be to search through the entire print version of the seven newspapers for each day of the 2 year time period. Overall, however, the use of the electronic databases was very helpful in reducing the amount of time and money spent tracking down articles about Andrea Yates and PPD and was most likely sufficient for the purposes of this study. Another limitation is that the method of exclusion for articles may not have been rigorous enough. More articles probably could have been discarded. By including articles about Yates’ trial and stories about Yates that did not necessarily discuss PPD, many stories were introduced that really were not about PPD at all or only mentioned it in a limited fashion and focused on other aspects of her case. When there was difficulty in determining if the article should be discarded, it was decided to err on the side of caution and many articles were included that, in retrospect, probably could have been discarded. Also, quite a few articles for the Chicago Tribune that were included for analysis came up under the heading “Across the Nation.” In hindsight, these articles probably were similar to articles from other newspapers’ “News in Brief”sections. Including these Tribune articles, as well as the ones noted above, may have influenced the final frames and results that were derived.

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104 One problem with this research was in the very issue of deciding if it was PPD that was being framed or the Andrea Yates case. While it was helpful to have a focusing event and case around which to center this study, (especially because otherwise there would not have been very many articles at all on PPD), sometimes it seemed to get in the way of looking purely at PPD and how it was framed. In answering the third question about differences in framing that occurred before, during, and after the Andrea Yates event, the researcher chose to look at which frames each article highlighted for those time periods, regardless of whether it discussed PPD or not, instead of just how PPD was framed specifically. Doing the latter would not have given a full or complete picture of how the articles were framed because many did not discuss PPD at all but were related to the Yates case. The problem may lie in the way the question was worded. Clarifying this problem more specifically would be helpful, if not essential, to future research on this issue. Suggestions for Future Research Even though the Andrea Yates case was extremely useful as a focusing event for researching newspaper coverage of PPD, future research focusing simply on PPD coverage in-depth over a longer span of time and not affiliated with a particular case might be a useful way to determine the consistency and fluctuation of PPD coverage over time. Although the purpose of this study was to discover what frames were used in the articles by analyzing the frequency of certain words, phrases and quotes, another possibility for future research would be to determine the major categories of frames before doing the content analysis and then code the articles into these categories. Research by Semetko and Valkenburg (2000) identified five news frames frequently used

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105 in earlier studies on framing and framing effects, which mostly paralleled the frames found in this study. The frames they identified were: attribution of responsibility, conflict, human interest, economic consequences, and morality. The attribution of responsibility frame could be seen as corresponding to the Blame Frame; the conflict frame with the Battle Frame; and the human interest frame with the Storyteller Frame. Although not corresponding so closely, the economic consequences frame could correlate to the Society Frame, or as a subcategory of it, while the morality frame could correlate to the Jekyll and Hyde Frame or the Society Frames. Another idea for future research would be to compare television coverage of the Andrea Yates case with print media coverage. There were quite a few references in the newspaper articles to electronic media coverage of the Yates’ case, and it would be interesting to see if framing of Andrea Yates and PPD differed significantly in the electronic and broadcast media from print media. Other ideas for future research opportunities would be to expand the range of print media analyzed by including magazines (particularly news magazines), which might provide more in-depth coverage. It also would be particularly interesting to look at women’s and health magazines coverage of PPD, given the research that suggests that women look to these magazines for health information (Lukachko & Whelan, 1999) . Comparing the gender and parental status of article writers to see how that affected attitudes toward PPD and the Andrea Yates case is another relevant idea for further research. A final suggestion would be to add international coverage to look at differences in framing by the various international countries as compared to the United States,

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106 particularly by those countries that limit the harshness of punishment that can be imposed on a woman who commits infanticide within the first year after birth. Conclusion Some might argue that the Andrea Yates case was not relevant to newspaper framing of PPD because she actually suffered from PPP, which is very rare in comparison to the number of women who are afflicted with the more common PPD. However, this author contends that Andrea Yates’ case indeed is relevant because PPP still is a form of PPD, and the milder conditions can worsen into this extreme and uncommon form if left untreated or if the woman has more pregnancies. A new mother who has given birth and is susceptible to suffering from PPD is very unlikely to develop PPP immediately without suffering milder symptoms first. And observing how newspapers either downplayed or played up the PPP aspect of PPD is extremely relevant and vital to understanding how they framed this condition, because this may have affected newspapers’ willingness to cover this issue. Ultimately, as is common with many other health issues that gain attention in the media for periods of time, this study indicates that PPD became a “trendy topic,” as noted by one newspaper reporter writing about it during this time. As long as it met the news value of timeliness and currency, coverage of PPD remained strong, but once Andrea Yates’ trial was over, this coverage quickly dropped. Thus, unfortunately, the lasting effects of this intensified interest in PPD are questionable. Most likely any lasting changes in the portrayal of PPD in the media may be on the regional level in the locations most affected by local cases, such as Chicago, Houston, and St. Petersburg. PPD is a predictable, preventable, and treatable condition. The more awareness is raised about it, the more will be done to educate and help the public and especially

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107 families and support networks of new mothers, with better methods of detection and prevention along with more effective postpartum assistance. With this help, not only will the mother be more likely to come through this rough period fully adjusted and joyful about her children, but also the children will grow up in the solidity and stability of a healthy family unit. It is hoped that this study will prompt further serious examination of this area of research. Depression is predicted by the World Health Organization (WHO) to become one of the top two causes of illness in the world by 2020 (Buist, 2001). Much research, public discussion and policy-making needs to be instigated in order to find the most just and humane way to handle such cases for all parties involved when the following facts are considered: The majority of people who suffer depression in any form are women Women have a two-fold higher incidence of depression than men Traditional supports for new mothers in American society have decreased There appears to be a trend toward harsher judgment of mothers who commit infanticide, as evidenced by the Andrea Yates case The mass media play an important role in relaying this information to the general public and keeping the issue alive in the public’s consciousness. The most significant implication of this study is that the media can make a crucial impact on how PPD and other mental health issues are perceived by the general public and key stakeholders by how they frame these issues. Thus, it can be argued that the media has a vital responsibility to frame these issues in a way to increase societal understanding. In the final analysis, the key hope stemming from this study is that enough knowledge about PPD will be distributed throughout all societies that could lead to the regular prevention of such tragic circumstances

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APPENDIX A CODING SHEET Newspaper or newsmagazine name: Date: Date of Week: Reporter’s Name: Newspaper/newsmagazine section: Page #: Word length of article, if available: Orgination: Local___ Guest/Freelance___ Wire___ Syndicate If wire or syndicate, please indicate the service by name:__________________________ Geographic level of item: Local___ State___ Regional___ National___ International___ Headline: Lead: Main topic of story: Secondary topic, if applicable: Is postpartum depression defined? _____ If yes, list definition: Sources used for direct quotes (list all, including affiliation): List the order of sources and who is given the most coverage and/or quote space: Note the source’s point of view on the PPD issue: 108

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109 Framing and framing techniques (mark directly on story): Read the item carefully several times. Paragraph by paragraph examine for the presence of key words and phrases, quotes, loaded words and phrases, tone symbols, figurative language, themes, visual images, quotation marks (which can be used to delegitimize), figures of speech to present or maintain particular themes and sources used and excluded, focus on events rather than issues (ignoring goals and missions and focusing on surface details). If focus is on issue, list what issues are brought up (legal, medical, gender-related, etc.). Note the dominant viewpoint. Note any secondary viewpoints. Indicate the frame that each quote is intended to advance or reinforce. Highlight examples of text from the item that illustrate the framing techniques that are used in the story. Note if there is a reference to Andrea Yates. Other comments

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APPENDIX B DESCRIPTIVE INFORMATION ABOUT ARTICLES Table B-1. Descriptive Information about Articles. Newspapers Average Word Count Article Sections Geographic Level Chicago Sun-Times1 Mean: 477 Range: 116 to 2011 News: 42 Editorial: 7 National: 31 Local: 18 Chicago Tribune Mean: 818 Range: 105 to 2358 Across the Nation: 11 News: 6 Family Sections: 6 Woman News: 5 Special Report: 4 Editorial/Commentary: 2 Metro: 2 National: 33 Local: 26 Houston Chronicle Mean: 682 Range: 139 to 1483 National : 28 Metfront: 15 Editorial: 5 National: 5 Local: 49 New York Post Mean: 433 Range: 100 to 920 Sections not available, only page numbers National: 34 Local: 1 New York Times Mean: 816 Range: 176 to 2162 National: 15 Health & Fitness: 4 Editorial/Op-Ed: 3 Magazine: 2 Week in Review: 2 Metropolitan: 2 National: 25 Local: 3 Foreign: 1 St. Petersburg Times Mean: 620 Range: 328 to 1030 City & State: 6 National: 3 Regional: 1 National: 4 Local: 8 USA Today Mean: 780 Range: 349 to 2383 News: 14 Commentary/Debate: 3 Features: 1 National: 18 Local: 0 1 A substantial amount of articles from both Chicago papers did not list a word count. The word count average was derived from half of articles or less. Many Chicago Tribune articles also did not list section. 110

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LIST OF REFERENCES Ackerman, T. (2001, June 21). Postpartum depression’s role doubted. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Ackerman, T. (2001, June 22). Yates had taken anti-psychotic drug/Husband says his wife used Haldol for a time. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): The American College of Obstetricians and Gynecologists [ACOG]. (1999, March). Postpartum depression. Retrieved December 11, 2003, from The Medem Network (Medical Library): The American College of Obstetricians and Gynecologists [ACOG]. (2002, January). Answers to common questions about postpartum depression. Retrieved December 11, 2003, from Anderson, K. (2001, June 22) . Analysis: US law and infanticide. BBC News Online. Retrieved December 10, 2003, from Andsager, J., & Smiley, L. (1998). Evaluating the public information: Shaping news coverage of the silicone implant controversy. Public Relations Review, 24(2), 183-201. Angle, M. (2001, June 22). Houston woman’s case points spotlight on illness; Mother treated for depression. USA Today. Retrieved September 24, 2001, from LexisNexis database (Academic): Aschoff, S. (2001, April 18). Postpartum depression can be severe. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Baker, D.G. (1999). The increase of single parent families: An examination of causes. Policy Sciences, 32(2), 175-188. 111

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112 Bard, J. (2002, March 13). Unjust rules for insanity. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Beck, C.T., & Gable, R.K. (2003). Postpartum depression screening scale (PDSS). Retrieved December 23, 2003, from Western Psychological Services: Bernstein, A., & Garcia, M. (2001, June 24). A life unraveled/Mom depicted as private, caring, burdened by hidden problems. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Birkland, T.A. (1998). Focusing events, mobilization, and agenda setting. Journal of Public Policy, 18(1), 53-74. Blumer, H. (1946). Collective behavior. In A.M. Lee (Ed.) Voting: A study of opinion formation in a presidential campaign. Chicago: University of Chicago press. Bridges, J.A., & Nelson, R.A. (2000). Issues management: A relational approach. In J.A. Ledingham & S.D. Bruning (Eds). Public relations as relationship management: A relational approach to the study and practice of public relations. (95-115). Mahwah, NJ: Lawrence Erlbaum. Brinig, M.F., & Buckley, F.H. (1999). The price of virtue. Public Choice, 98(1-2), 111-129. Brotman, B. (2001, June 27). Where to turn for help. Chicago Tribune. Retrieved May 13, 2003, from Buist, A. (2001, March-April). Treating mental illness in lactating women. Medscape Womens Health, 6 (2): U30-U39. Carson, R. (2001, June 26). No easy answer: Proving insanity could be tough for Houston mom accused of killing kids. ABC NEWS. Retrieved December 19, 2003, from (U.S.): Christian, C. (2002, February 26). Vision of knife, voice of Santa haunted Yates, doctor testifies. The Houston Chronicle. Retrieved April 28, 2003, from LexisNexis database (Academic): Condor, B., & Brotman, B. (2001, June 27). In the shadows of birth. Chicago Tribune. Retrieved May 13, 2003, from Connor, T. (2002, January 8). Picking killer-mom jury could last month. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic):

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113 Davis, R. (2001, April 16). Mother’s case casts light on ‘baby blues.’ St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Davis, R. (2001, May 4). Mothers’ mental health a priority. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Deardorff, J. (2001, June 24). A 2nd look at a mother’s crime; A woman who says postpartum depression moved her to kill her children in 1985 gains support as she fights for clemency. Chicago Tribune. Retrieved May 13, 2003, from Deardorff, J., & Hepp, R. (2001, June 12). Mom with postpartum illness falls to death from 12th floor ‘Monster in my daughter’s brain.’ Chicago Tribune. Retrieved July 6, 2003, from Delfiner, R. (2002, March 14). Yate faces fate in death penalty, USA. New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Della Cava, R., & Oldenburg, A. (2001, July 3). It must be asked: Where was the dad? Difficult questions haunt father of drowned children. USA Today. Retrieved October 30, 2001, from Dobson, V., & Sales, B. (2000). The science of infanticide and mental illness. Psychology, Public Policy and Law, 6(4), 1098-1112. Easton, P. (2001a, June 22). Dad says depression was fatal; Vows to support wife accused of killing their kids. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Easton, P. (2001b, June 22). Wife’s depression blamed for killings; Tearful husband shows support after loss of 5 kids. Chicago Tribune. Retrieved May 13, 2003, from Easton, P. (2001a, June 23). Depressed mother’s oldest child tried to flee. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Easton, P. (2001b, June 23). ‘Zombie-like’ mom details drowning of her 5 children. Chicago Tribune. Retrieved May 13, 2003, from Entman, R. (1993). Framing: Toward clarification of a fractured paradigm. Journal of Communication, 43(3), 51-58.

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114 Epstein, R.H. (2001, December 4). Cases; So lucky to give birth in England. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Feldman, C. (2001, June 26). Yates case draws attention to new moms’ mental health/Baby blues. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Feldman, C. (2002, February 4). Grief that never ends; Two fathers share remarkably similar losses as they struggle to go on with life after the tragic deaths of their children. The Houston Chronicle. Retrieved April 28, 2003, from Fleming, A.T. (2002, March 17). Ideas & trends: Crime and motherhood; Maternal madness. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Freeman, M.P., Keck, P.E., & McElroy, S.L. (2001). Postpartum depression with bipolar disorder. The American Journal of Psychiatry, 158(4), 652. Fritz, S. (2001, September 10). Drownings are tragedy, not politics. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Gans, H.J. (1983). News media, news policy, and democracy: Research for the future. Journal of Communication, 33, 174-184. Geller, A. (2001, July 1). [no headline] The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Georgiopoulos, A.M., Bryan, T.L., Wollan, P., & Yawn, B.P. (2001). Routine screening for postpartum depression. The Journal of Family Practice, 50(2), 117-122. Glenn M., Rendon R., Bernstein A., Ackerman T., Carreau M., Christian C., Garcia, M., O’Hare, P., Lezon, D., Rodrigues, J. (2001, June 21). Mom of 5: ‘I killed my kids’; Children may have died in tub. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Gitlin, T. (1980). The whole world is watching: Mass media and the making and unmaking of the new left. Berkeley: University of California Press. Glenn, M., Rendon R., Bernstein, A., Ackerman T., Carreau M., Christian C., Garcia, M., O’Hare, P., Lezon, D., Rodrigues,J. (2001, June 21). Mom of 5: ‘I killed my kids’; children may have died in tub. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Gotti, V. (2001, July 1). [no headline]. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic):

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115 Hepp, R. (2001, June 15). Mom’s death seen as lesson to others ‘Term we knew nothing about.’ Chicago Tribune. Retrieved July 6, 2003, from Herbert, B. (2001, July 5). In America; Empathy for a killer. The New York Times. Retrieved October 30, 2001, from Herbert, B. (2002, March 18). Deciding who will live. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Holmes, A. (2001, June 29). Mom who killed her kids wasn’t a victim. USA Today. Retrieved October 30, 2001, from database (Political/General News): Huang, Y-C, & Mathers, N. (2000). Postnatal depression – biological or cultural? A comparative study of postnatal women in the UK and Taiwan. Journal of Advanced Nursing. 33(3), 279-287. Hunter, B. (2001, June 24). Her dad’s death made killer mom snap: bro. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Hunter, B. (2002, January 31). ‘Devil’ drove mom to murder. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Johnston-Robledo, I. (2000). From postpartum depression to the empty next syndrome: The motherhood mystique revisited. In J.C. Chrisler, C. Golder, & P.D. Rozee (Eds.) Lectures on the psychology of women (2nd ed.) (pp. 128-147). New York: McGraw-Hill. Jones, C., (2001, June 22). Kids’ dad defends his wife; Texas mom could face death in 5 drownings. USA Today. Retrieved October 27, 2001, from LexisNexis database (Academic): Jury to be selected in tub-tots slay. (2002, January 7). The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Krauthammer, C. (2002, March 18). Sending out the wrong message on mental illness. Chicago Tribune. Retrieved July 2, 2003, from LaMendola, B. (2000, October 29). Blues can color dad’s world too. Chicago Tribune. Retrieved July 6, 2003, from LaMendola, B. (2000, November 26). New-baby blues color father’s world too. Chicago Tribune. Retrieved July 6, 2003, from

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116 Lane, J.B. (1998, December). The framing of Title IX: A textual analysis of The New York Times and The Washington Post, 1971-1975. Paper presented at the meeting of Association for Education in Journalism and Mass Communication, Baltimore, MD. Laney, M. (2001, July 25). Doctors need to help depressed mothers. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Laney, M. (2002, March 3). The real outrage in kids’ drowning. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Leggatt, J. (2002, March 27). In search of answers after final verdict in Andrea Yates trial. International Network on Personal Meaning (INPM). Retrieved December 20, 2003, from Lehman, J. (2001, June 22). Dad says depression was fatal; Vows to support wife accused of killing their kids. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Lehman, J. (2001, June 29). Killer-mom bombshell; Tried 2nd suicide just months before drownings. The New York Post. Retrieved June 5, 2003, from LexisNexis database (Academic): Long, S., & Geller, A. (2002, March 16). Yates dodges death penalty: Jury needs just 39 minutes to give her life term in tub slay. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Long, S., & Hunter, B. (2002, March 6). Killer mom drowned kids to ‘save’ them from Satan. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Lukachko, A., & Whelan, E.M. (1999, March). You’ve come a long wayor have you?: Popular women’s magazines are still downplaying the risks of smoking. American Council on Science and Health (ACSH). Executive Summary retrieved December 29, 2003, from Lush, T., & Fields, M. (2001, April 18). Missing mom is found dead. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Lyons, W., Schieb, J.M., III, & Richardson, L.E., Jr. (1995). American government: Politics and political culture. Minneapolis: MN: West.

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117 Maher, T.M. (2001). Framing: an emerging paradigm or a phase of agenda setting?. In S.D. Reese, O.H. Gandy, Jr., & A.E. Grant (Eds.), Framing public life: Perspectives on media & our understanding of the social world (pp. 83-94). Hillsdale, NJ: Lawrence Erlbaum. Manier, J. (2001, June 23). Postpartum disorder eludes easy answers. Chicago Tribune. Retrieved May 13, 2003, from Martinez, R., Johnston-Robledo, I., Ulsh, H.M., & Chrisler, J.C. (2000). Singing “The Baby Blues”: A content analysis of popular press articles about postpartum affective disturbances. Women & Health, 31(2/3), 37-56. Mayo Clinic Staff. (2002, February 13). Postpartum coping: The blues and depression. Retrieved December 20, 2003, from McCartney, H.P. (1987). Applying fiction conflict situations to analysis of news stories. Journalism Quarterly, 64, 163-170. McCombs, M.E., Einsiedel, E., & Weaver, D. (1991). Contemporary public opinion: Issues and the news. Hillsdale, NJ: Lawrence Erlbaum. McCombs, M.E., and Shaw, D.L. (1993). The evolution of agenda-setting research: Twenty-five years in the marketplace of ideas. Journal of Communication, 43, 58-67. McNamara, J.D. (2002, March 12). Remember crimes’ brutality. USA Today. Retrieved July 9, 2003, from Retrieved October 30, 2001, from McRoberts, F. (2002, February 18). Mom’s mental illness on trial; Texas jury to weigh issue in killing of 5. Chicago Tribune. Retrieved May 13, 2003, from Mellen, K. (2001, June 27). In the shadows of birth; why the illness often falls through health-care cracks. Chicago Tribune. Retrieved May 13, 2003, from Melone, M.J. (2001, April 22). Pangs of doubt cloud the joy of a new life. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Melone, M.J. (2002, March 17). Abandoned by sanity, victimized by ignorance. St. Petersburg Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Mencher, M. (2000). News reporting and writing (8th ed.), (p.68). Columbia University: McGraw-Hill Higher Education.

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118 Meyer, C.L., & Oberman, M. (2001). Mothers who kill their children: Understanding the acts of moms from Susan Smith to the “Prom Mom.” New York and London: New York University Press. Miller, M.M., & Riechart, B.P. (2001). The spiral of opportunity and frame resonance: mapping the issue cycle in news and public discourse. In S.D. Reese, O.H. Gandy, Jr., & A.E. Grant (Eds.), Framing public life: Perspectives on media & our understanding of the social world (pp. 195-205). Hillsdale, NJ: Erlbaum. Milloy, R. (2001, September 23). Texas mother to face trial in drownings. The New York Times. Retrieved October 30, 2001, from Mitchell, M. (2001, July 20). Why did she have to die? Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Mom’s sanity focus of drowning trial; Texas woman faces death in 5 kids’ slayings. (2002, January 4). USA Today. Retrieved October 30, 2001, from The National Women’s Health Information Center [NWHIC]. (2002, July). Women and Postpartum Depression. Retrieved September 24, 2001, from Nelkin, D. (1989). Journalism and science: the creative tension. In Mike Moore (Ed.). Health Risks and the Press (pp. 53-71). Washington, DC: The Media Institute. Nevala, A., & Yednak, C. (2001, July 19). Divers find missing mom; Southwest Side woman’s body pulled from lake. Chicago Tribune. Retrieved May 13, 2003, from Palenchar, M. (2001, August). Media Coverage of Risk Events: A Framing Comparison of Two Fatal Manufacturing Accidents. Paper presented at the meeting of the Association for Education in Journalism and Mass Communication, Washington, DC. Pariser, S.F., Nasrallah, H.A., & Gardner, D.K. (1997). Postpartum mood disorders: Clinical perspectives. Journal of Women’s Health, 6(4), 421-434. Park, R.E. (1972). The crowd and the public and other essays. Chicago: University of Chicago Press. (Originally published in 1904). Parker, K. (2001, August 15). Yates should not face death penalty for child drownings. Chicago Tribune. Retrieved May 13, 2003, from Parker, L. (2001, August 28). Coalition supports Houston mom. USA Today. Retrieved October 30, 2001, from

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119 Parker, L. (2002, February 18). Houston case tests insanity plea; Arguments set to begin in trial of mother who drowned kids. USA Today. Retrieved October 30, 2001, from Parker, L. (2002, March 15). Verdict shows ‘gap’ between laws, scientists. USA Today. Retrieved October 30, 2001, from Parker, L. (2002, March 18). Rusty Yates: ‘Didn’t know she was psychotic.’ USA Today. Retrieved July 9, 2003, from Peyser, A. (2001, June 28). This mother won’t pay, either. The New York Post. Retrieved April 28, 2003, from from LexisNexis database (Academic): Peyser, A. (2002, February 19). Kill? She just interrupted 5 tiny lives. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Peyser, A. (2002, March 13). Justice has last laugh on despicable murderer. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Peyser, A. (2002, March 16). There was a second psycho in that household. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Podhoretz, J. (2001, June 26). The murdering mom and the prison of self. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Podhoretz, J. (2001, June 29). A deadly excuse; the peril in blaming depression for Yates’ crime. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Police and family search for missing S. Side mom. (2001, June 11) . Chicago Tribune. Retrieved July 6, 2003, from Post Wires Services. (2001, July 4). Yates lawyers signal insanity defense. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Postpartum risks of new moms. (2001, June 15). Chicago Tribune. Retrieved July 6, 2003, from Report: Yates claimed devil possession. (2002, January 21). The Houston Chronicle. Retrieved April 28, 2003, from

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120 Richards, C. (2001, June 27). Maternity needs lots of TLC; Having a baby can be a massively overwhelming experience, for first-time or for fifth-time moms. Chicago Sun-Times. Retrieved April 28, 2001, from LexisNexis database (Academic): Ritter, J. (2001, June 12). Postpartum psychosis hits 1 mother in 1,000. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Ritter, J. (2001, June 22). Postpartum psychosis rare, but nothing new, experts say. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Rotzoll, B.W. (2001, June 9). ‘It was sort of like goodbye’; New mom vanishes after treatment for postpartum psychosis. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Rotzoll, B.W. (2001, June 10) . Baby’s mother vanishes; Postpartum illness could cause suicide, family fears. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Rotzoll, B.W. (2001, July 20). Some good comes of tragedies. Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Rotzoll, B.W. (2001, July 22). Pregnancy getting tougher? Chicago Sun-Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Rush starts push for postpartum bill. (2001, July 4). Chicago Tribune. Retrieved May 13, 2003, from Sammons, M.B. (2001, October 21). Dads’ healing touch; Fathers recruited in the fight against postpartum depression. Chicago Tribune. Retrieved May 13, 2003, from Semetko, H.A., & Valkenburg, P.M. (2000). Framing European politics: A content analysis of press and television news. Journal of Communication, 50, 93-109. Slater, L. (2001, July 8). The way we live now: 07-08-01; Beginning and end. The New York Times. Retrieved October 30, 2001, from Snyder, M. (2002, March 13). Russell Yates on trial, too, with public’s sympathy. The Houston Chronicle. Retrieved April 28, 2003, from Staff. (2001, August 12). Life, death issues/Gag order or not, some Yates questions must await trial. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic):

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121 Starr, M. (2001, August 15). ‘Today’ plugs killer mom’s defense fund. The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Stasi, L. (2001, July 1). Can we can the trash talk? The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Stoltz, M.E. (2002, April 28). Opinion; Financial neglect of mental illness. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Teachey, L. (2001, July 31). Yates’ lawyers plan to enter insanity plea. The Houston Chronicle. Retrieved April 28, 2003, from Teachey, L. (2001, August 24). NOW will raise funds for Yates’ legal defense/Spotlight placed on depression issue. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Teachman, J.D., Tedrow, L.M., & Crowder, K.D. (2000). The changing demography of America’s families. Journal of Marriage and the Family, 62(4), 1234-1246. Texas law leaves jurors with flawed choice. (2002, March 12). USA Today. Retrieved July 9, 2003, from Thomas, E. (2001, July 2) . Motherhood and Murder. Newsweek, 21-25. Tolson, M. (2001, July 1). Hawaii killings eerily similar to Yateses’. The Houston Chronicle. Retrieved April 3, 2003, from Tolson, M. (2001, September 10). Unequal justice/Criminal punishment widely disparate in maternal filicide cases such as Yates. The Houston Chronicle. Retrieved September 24, 2001, from LexisNexis database (Academic): Vogell, H. (2001, June 10). Missing mother had been depressed; Behavior change followed birth. Chicago Tribune. Retrieved July 6, 2003, from Walsh-Childers, K. (1994). Newspaper influence on health policy development. Newspaper Research Journal, 15, 89-104. Warren, A. (2001, June 26). Another life/Friends say Yates they knew couldn’t hurt anyone. The Houston Chronicle. Retrieved April 3, 2003, from Wiener, R. (2001, June 22). American justice can be tough on postpartum depression. LexisONE. Retrieved November 13, 2001, from

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122 Williams, D. (2002, February 27). Postpartum psychosis: A difficult defense. Retrieved December 19, 2003, from (Law Center): Winsten, J.A. (1985). Science and the media: The boundaries of truth. Health Affairs, 4, 5-23. Wire reports. (2001, August 28). NOW supports mother of drowned children. Los Angeles Times. Retrieved September 24, 2001, from LexisNexis database (Academic): Yardley, J. (2001, July 2). Child-death case in Texas raises penalty questions. The New York Times. Retrieved September 24, 2001, from LexisNexis database (Academic): Yardley, J. (2001, August 9). Death penalty sought for mother in drownings of children. The New York Times. Retrieved September 24, 2001, from LexisNexis database (Academic): Yardley, J. (2001, August 12). August 5-11; Texas woman to face death. The New York Times. Retrieved October 30, 2001, from Yardley, J. (2001, September 8). Despair plagued mother held in children’s deaths. The New York Times. Retrieved September 24, 2001, from LexisNexis database (Academic): Yardley, J. (2002, January 9). Prosecutor willing to deal in child drownings case. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Yardley, J. (2002, February 19). Trial opens in case of drowned children. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Yardley, J. (2002, March 13). Texas jury convicts mother who drowned her children. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Yardley, J. (2002, March 16). Mother who drowned 5 children in tub avoids death sentence. The New York Times. Retrieved April 28, 2003, from LexisNexis database (Academic): Yates lawyers signal insanity defense. (2001, July 4). The New York Post. Retrieved April 28, 2003, from LexisNexis database (Academic): Yates says couple made joint decisions. (2002, March 1). Chicago Tribune. Retrieved May 13, 2003, from

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123 Zoch, L.M. (2001). What’s really important here?: Media self-coverage in the Susan Smith murder trial. In S.D. Reese, O.H. Gandy, Jr., & A.E. Grant (Eds.), Framing public life: Perspectives on media & our understanding of the social world (pp. 195-205). Hillsdale, NJ: Lawrence Erlbaum.

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BIOGRAPHICAL SKETCH Laura A. Schmid grew up in St. Petersburg, Florida. She received her Bachelor of Arts degree in English (with a Psychology minor) from Stetson University in DeLand, Forida in 1992. The fourth child of an Army career father, she was born in the Panama Canal Zone and lived in Germany for 4 years before moving to Florida in 1976. She studied abroad in Nottingham, England, during her junior year of college, and after graduation lived in Missouri, Chicago, and Raleigh, North Carolina. Before entering graduate school at the University of Florida, she worked at an urban homeless youth shelter, hospital administrative offices, a property management company, and Barnes and Noble Bookstores (one of her favorite jobs, given her openly-admitted bookworm status). 124