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November/December 2015 Issue

Adoption Trends Today
By Deborah H. Siegel, PhD, LICSW, DCSW, ACSW
Social Work Today
Vol. 15 No. 6 P. 18

Over the past several decades, views about adoption, the language of adoption, who is adopting, and who is being adopted have all changed.

Many people think pregnant, unmarried teenagers compose the majority of biological mothers placing their babies for adoption. The reality today is that the typical profile is more commonly a pregnant 20-something who is already parenting at least one other child. The most likely adoption scenario today does not involve someone voluntarily terminating parental rights to an infant; rather, it is the adoption of an older child from foster care, whose parents' rights have been involuntarily terminated.

There are also changes today in who adopts. At one time, only young, infertile, married couples were allowed to adopt; today, adoptive parents are an extremely varied group, including people who are beyond childbearing age, divorced, unmarried, gay, lesbian, and fertile. There have been many other major changes in the adoption landscape over the last few decades as well. Many of today's adoption-related laws, policies, and practices, created decades ago, no longer fit today's adoption realities, according to Adam Pertman of the National Center on Adoption and Permanency.

There has been a shift in the kinds of children needing adoptive families, where those children come from, who their original parents are, the kinds of families that adopt them, and the evidence-based principles now considered best practice for adoption policy and practice. Many misconceptions about adoption persist among the general public and among social workers, because most professionals in the field have not had sufficient, if any, adoption education.

Language and Views Have Changed
The language people use both reflects and shapes reality. For example, the term "birth parent" is no longer preferred during the preadoption planning phase; the terms "expectant parent," "first parent," or "original parent" are used instead, because calling them "birth parents" before they have terminated parental rights can be a form of subtle coercion, casting them into a role that assumes adoption will occur.

The new language is more factually accurate, neutral, respectful, and empowering.
Similarly, the phrase "gave her baby up for adoption" is no longer viewed as acceptable. Rather, "made an adoption plan" is preferred, as it conveys that adoption is a proactive decision by original parents who want to do their best for their children, not as people who give away something they do not want or value.

The term "adoption triad" is also eschewed as simplistic and reductionist. The preferred terms, instead, are "the extended family of adoption," "the adoption circle," or "the adoption constellation" in order to capture the realities that adoption joins a child's extended biological and adoptive families in a complex interpersonal network influenced by many societal institutions that play a role in the process.
Further, today we recognize that every person's genetic and cultural roots matter, and that attempts to sever the child's emotional connection to and contact with the family of birth cause harm. Adoption, like marriage, joins families. The roles that clarity, boundaries, communication skills, self-awareness, honesty, respect, trust, and tact play to make marriages and extended biological families function well also help adoption relationships thrive.

The vast majority of infant adoptions in the United States today involve some form of openness; the child's original parents and adoptive parents exchange identifying information and have some form of contact before and after the adoption is finalized. There is wider acceptance of the fact that children are best served when they maintain family connections and have access to ongoing communication with their original parents. For example, lifesaving health care information may be unknown to the child's original family at the time of the adoption, so the ongoing communication between the original and adoptive families is essential for the child's emotional and medical well-being.

At one time, prospective adoptive parents may have pursued intercountry adoption in order to avoid dealing with original parents, but today an increasing number of adoptive parents are more informed about the importance of preserving family connections and are creating open adoption relationships with their children's original families abroad, before and after finalization. The Internet facilitates these connections in ways not possible in years past.

Decades ago, adoptive parents were generally told, "You must resolve your infertility issues before you can adopt." They were also advised to raise the children they adopted as if those children had been born to them, not to talk about the adoption, and maybe even not to tell their sons and daughters that they were adopted—all in an effort to "protect" the children from the stigma of illegitimacy and the adults from the shame of not having been able to conceive. Nearly all states passed laws sealing original birth certificates in perpetuity, and new birth certificates were created containing the legal fiction that the adopted children were born to their adoptive parents.

Birth parents were told that it was their moral duty to terminate their parental rights so stable, married couples could raise their children. Sex out of wedlock was widely viewed as unacceptable, particularly for women who "got themselves pregnant" and thus did not deserve to parent their children. The original mothers were advised not to see or hold their newborn infants, to put the birth and adoption behind them and just get on with their lives. The original fathers were seen as irrelevant, obstacles, and annoyances; their parental rights were even less legally protected than they are today. People believed that psychologically well-adjusted original parents and adoptees had no need to grieve their losses, no need for further information about or contact with each other, and no adoption-related feelings to process.

Today, we know that the pain and losses embedded in infertility, parting with a child through adoption (even when it's an informed decision made without coercion), or losing one's original family through adoption are significant, often traumatic experiences that entail grief, loss of control, shame, guilt, rejection, bewilderment, anger, issues with intimacy and identity, and a host of other feelings that evolve over the lifespan but may reemerge from time to time and that, for many, never entirely disappear.

A growing number of states now allow adopted people, upon adulthood, to access their original birth certificates, understanding that closure laws passed in the 20th century ostensibly to protect people actually harmed them instead. The voices of adopted people, first parents, adoptive parents, and professionals in the field over the decades have been part of a larger civil rights movement, so today about 90% of all new infant adoptions include some level of openness.

There is now a large body of research showing the positive impact of open communication within families about adoption, and the workability of ongoing contact among children's adoptive and biological kin. In addition, promises of secrecy, and promises not to communicate after the adoption occurs, cannot be honored today, as the Internet makes it increasingly possible for people to find each other and maintain contact. During the preadoption preparation phase and beyond, original parents and adoptive parents today need education and support that enables them to ready themselves for the possibility that their child may use the Internet and social media to establish contact with relatives, even without their parents' knowledge or support. Hence, open communication within and between families is upon us, even among those who cling to discredited ideas about the need for secrecy and no contact.

Given the emotional complexities embedded in severing parental rights, there is greater understanding today that original parents need competent preadoption counseling and easy access to affordable, quality family support and preservation services before parental rights are terminated. Similarly, given the issues embedded in parenting a child born to someone else, adoptive parents need thorough preplacement education about the issues that come with adoption and how to address them with their children. All members of the circle of adoption need access to competent postadoption services, as we recognize today that adoption is not an event but a lifelong journey that presents normative developmental challenges from one life stage to the other, for everyone in the adoption circle.

The role of first fathers has also changed. It is now best practice to include them as important, necessary participants in the preadoption exploration and planning process; indeed, failure to do so has led to tragic, highly publicized cases. First mothers and fathers are encouraged to have voices and choices; many first fathers, along with the child's first mother, choose the adoptive family. Some state laws also afford first fathers and mothers the opportunity to negotiate legally enforceable postadoption contact agreements. Sadly, manipulation and deceit still occur, including when preadoptive parents agree to contact and then renege after the adoption is finalized, with no legal recourse available to the original parents.

Who Gets Adopted
Today, domestic adoptions of white infants are relatively few—about 15,000 each year. The majority of adoptions today, 50,000, excluding adoptions by stepparents, are of children who entered the child welfare system due to abuse or neglect by their original parents. Most of these children have suffered traumatic losses, are no longer infants, are of color, are in sibling groups that should be placed together, and/or have special physical, learning, or behavioral health needs that have been identified or are yet to emerge. Each of these circumstances requires informed and skilled parenting; hence, all prospective adoptive parents are best served when they enter adoption knowing it is possible they may need specialized support services down the road.

Simultaneously, the number of intercountry adoptions has declined precipitously worldwide, from 45,000 in 2004 to about 19,500 in 2013 (Pinderhughes et al., 2013). This is due to many factors within countries of origin, in addition to the impacts of the Hague Convention on Intercountry Adoption, which created international standards designed to enhance efforts to place children with biological kin, keep them in their home countries, and limit exploitation and illegal activities such as baby selling. As a result, more children today remain in orphanages abroad for longer periods of time, suffering the negative impacts of institutionalization (Pertman, 2015).

Intercountry adoptions into the United States have fallen from a high of nearly 23,000 in 2004 to 6,441 in 2014. The cost of an international adoption has also risen, often to more than $50,000. At present, the countries from which children are most frequently adopted into the United States are China (2,040 children), Ethiopia (716), and Ukraine (521). Other countries that previously allowed adoption of their children have closed their doors entirely. Most countries of origin now permit intercountry adoption primarily or exclusively for children who have special needs, are older, or are in sibling groups (Bureau of Consular Affairs, 2015; Pinderhughes et al.).

Many social workers may be surprised to learn that the United States not only receives children from other countries but also allows children born in this country to be adopted abroad; in fiscal year 2014, 96 children were adopted out of the United States, and since 2008 the number is greater than 400 (Bureau of Consular Affairs).

Internet's Impact
The Internet and social media have created some positive changes in adoption. First parents, adopted people, and adoptive parents have easier access, via technology, to support from others who share their situations. Access to pre- and postadoption information is also available at one's fingertips; however, not all of that information is legitimate, and it can be hard to discern quality. Other challenges have also come with digital communication.

Within the United States, the Internet and social media have revolutionized the ways expectant parents and prospective adoptive parents find each other in order to make an adoption plan. Electronic media has changed the ways agencies recruit foster and adoptive families and share profiles of children waiting to be adopted. Facebook and other social media platforms have opened new doors to adopted people—sometimes including young children—who are now able to locate and communicate with biological kin without adoptive or first parents knowing. This has led to complex, sometimes volatile emotional issues for children and parents to manage.

The Internet and social media have also revolutionized the search and reunion process, likely leading to the end of closed adoption, as wide new avenues for locating lost relatives are now readily available at the touch of a keyboard.

Some unscrupulous, aggressive for-profit adoption brokers on the Web are using technology for illicit gain, both by promising quick access to babies for people who want to adopt and by luring pregnant women to relinquish their babies with promises of remuneration, services, and other inducements. In short, the Web has contributed to commercializing adoption and treating children as commodities (Whitesel & Howard, 2013).

"Rehoming," the unmonitored, unregulated use of the Internet to transfer children from one family to another, is another disturbing development. The process typically involves children adopted from abroad by U.S. parents who feel unable to handle their children's medical or behavioral health issues, and who cannot find the services or supports they need.

Clinical Challenges
Policy and practice in the United States focus largely on "child placement," often including financial benefits for agencies to make adoptions happen; there are few incentives, however, to provide the education, training, and lifelong postadoption support services that many adoptive and first families need. Once an adoption is finalized, many agencies terminate services, leaving first and adoptive families to navigate the maze of challenging issues across the lifespan without necessary clinical care.

According to research, "adoptive families are three to four times more likely to seek counseling for their children, and five to seven times more likely to seek residential treatment, than are birth families. … While some of this difference may be due to a greater willingness to seek help, it also is indicative of a higher level of challenges" (Smith, 2014). Many adoptive parents are unable to find adoption-competent mental health providers.

A Peek at the Future
Complex, diverse, extended family networks of adoptive and biological kin are here to stay. Fortunately, most adopted people, including those born with challenges or who have endured trauma, function well, and the vast majority of adoptive parents are satisfied with their adoptions (Vandivere, Malm, & Radel, 2009).

It is also true, however, that accessible, affordable, high quality services for both original and adoptive families are needed, so every child can be raised in a safe, nurturing, permanent home in which all family members thrive. Ideally, all children would be able to grow up well cared for in their families of origin so adoption would not be needed. When adoption is necessary, lifelong access to high quality pre- and postadoption support services should be provided. Pursuing this vision is a crucial agenda for social work.

— Deborah H. Siegel, PhD, LICSW, DCSW, ACSW, is a professor in the School of Social Work at Rhode Island College, a clinician specializing in adoption issues, an adoption researcher, and an adoptive parent.

Bureau of Consular Affairs, U.S. Department of State. (2015). FY 2014 Annual report on intercountry adoption.
Retrieved from http://travel.state.gov/content/dam/aa/pdfs/2014_Annual_Report_on_Intercountry_Adoptions_Narrative.pdf.

Pertman, A. (2015). Reshaping adoption and child welfare: Progressing from 'child placement' to 'family success.' Retrieved from www.nationalcenteronadoptionandpermanency.net.

Pinderhughes, E., Matthews, J., Deoudes, G., & Pertman, A. (2013). A changing world: Shaping best practices through understanding of the new realities of intercountry adoption. Retrieved from http://adoptioninstitute.org/old/publications/2013_10_AChangingWorld_ExecSum.pdf.

Smith, S. (2014). Keeping the promise: The case for adoption support and preservation. Retrieved from http://adoptioninstitute.org/wordpress/wp-content/uploads/2014/05/Keeping-the-Promise-Case-for-ASAP1.pdf.

Vandivere, S., Malm, K., & Radel, L. (2009). Adoption USA: A chartbook based on the 2007 national survey of adoptive parents. Retrieved November 23, 2009, from http://aspe.hhs.gov/hsp/09/NSAP/chartbook/index.pdf.

Whitesel, A., & Howard, J. A. (2013). Untangling the Web II: A research-based roadmap for reform. Retrieved from http://adoptioninstitute.org/old/publications/2013_12_UntanglingtheWeb2_ExecSum.pdf.