Test Your Knowledge

Adoption is the legal transfer of parental rights over a child from the birth parent(s) to adoptive parent(s). In 1944, adoptions hit an all-time low of 50,000 and peaked in 1970 at about 175,000, according to the Adoption Institute. Today, the average number of adoptions is around 127,000 adoptions per year in the United States, according to the Centers for Disease Control and Prevention (CDC).

There are more than 1.5 million adopted children in the United States. According to a report from the CDC, the prevalence of adoption increases with the age, education and income level of the prospective parents.

There are many reasons to choose adoption to begin or expand a family. For instance, in the United States there are over 6 million women in their childbearing years with an impaired ability to have children. Approximately 11 percent of infertile couples in the United States pursue adoption as an alternative means of creating a family, according to the CDC. Single-parent households and same-sex partnerships are other common reasons for adoption.

Prior to adoption, some basic factors regarding the process must be considered, including:

• International or domestic adoption
• Private agency or public agency
• Open adoption, semi-open adoption or closed adoption

Prospective parents must typically participate in a home study prior to the adoption. This is a comprehensive evaluation of each person living in the prospective adoptive parents’ home. An adoption home study is typically conducted by a social worker and will focus on a number of factors that can impact raising a child.

Depending on the type of adoption and the state in which a woman lives, certain factors may increase her odds of being approved for adoption. These may include:

• Being married and with the partner for a minimum of three years
  
• No more than 40 years older than the child to be adopted
  
• Good health
  
• Infertility
  
• Less than three existing children
  
• Financially stable
  
• Child-friendly house
  
• Ability of an adoptive parent to remain at home with the adopted child for six months after adoption

There is an increasing number of unmarried or homosexual women, either single or in partnerships, being approved as adoptive parents. However, the rules on who may adopt vary from state to state, and some states do not permit unmarried individuals or homosexuals to adopt children.

Once a child is placed with a permanent family, the adoptive parents will need to schedule a physical examination with a pediatrician. Prior to the examination, the adoptive family should attempt to gather as much information about the child’s medical history and family history as is possible. This information will aid the physician in evaluating the child’s health and can provide insight into potential medical problems or conditions. It is recommended that this exam take place three to four weeks after placement to allow the child time to acclimate before subjecting him or her to possible medical tests. Some of the health conditions for which an adoptive child is screened can include:

• Anemia
• Blood lead levels
• Developmental delays or impairments
• Hepatitis B and C infection
• HIV
• Intestinal parasites
• Impaired hearing and vision
• Metabolic disorders
• Psychological problems (e.g., attachment disorders)
• Fetal alcohol syndrome or the evidence of maternal drug use during pregnancy
• Rickets
• Syphilis
• Thyroid conditions 
• Tuberculosis

The pediatrician will carefully screen for these and other signs of illness during the examination. It is common for adopted children to be susceptible to colds, minor infections, upset stomachs and diarrhea shortly after their arrival in their new permanent surroundings. At times, these conditions can be caused by an exposure to new types of germs, possibly variables in a new diet or emotional influences.

In addition to minor colds and illnesses, children who are adopted from foreign countries may face other medical challenges. However, many of these complications may be resolved following a short period of adjustment to a new home. For more persistent problems, the adoptive parents should contact an appropriate healthcare professional.

There is certain information that will help make a smoother transition in terms of meeting an adopted child’s medical needs. It is recommended that adoptive parents make an effort to obtain the following information through the agency or attorney:

• The birth parents’ ages, ethnic backgrounds, education levels, occupations, heights, weights and current medical conditions or family history of serious illnesses
  
  
• Medical history of siblings, if available
  
  
• Lifestyle choices of the birth mother that could affect the health of the child (e.g., the use of alcohol, tobacco, recreational drugs or the presence of any sexually transmitted diseases during pregnancy)
  
  
• The extent of the birth mother’s prenatal care
  
  
• Test results from any examinations that took place during pregnancy
  
  
• Information on any problems that arose during pregnancy, labor or delivery
  
  
• The weight, length and head circumference of the child at birth, as well as any developmental measurements
  
  
• Information on any medical problems the child may have experienced
  
  
• Results from any medical examinations
  
  
• Information from the child’s caretakers (foster parents, social workers, etc.) that can offer insight into the child’s personality and relationships with others
  
  
• Knowledge of any physical, sexual or emotional abuse of the child

Adoptions must be finalized in court, regardless of the child’s origin. The process will vary from state to state depending on adoption laws.