• In adoption, a birth parent places the child in the care of another person or family in a permanent, legal agreement.
  • The birth parent selects the type of adoption (open vs. closed) and may influence who will facilitate the process (agency, attorney, facilitator).
  • Social workers are a helpful resource for patients navigating adoption.
  • Prospective adoptive parents undergo an evaluative home study, which includes interviews, home visits, health evaluation, income, and references (NAICH 2004).
  • The birth parent may be given a limited period of time during which they may change their mind. After that, the courts reverse few adoptions.
Open Closed/Confidential
In open adoption, the birth parent may select and have contact with the adopting family (through ongoing visits, phone calls, pictures, or through an intermediary). Birth parents may choose open adoption to be reassured and maintain contact as the child grows. In closed or confidential adoption, the birth parent and adopting parents have no contact, but do share relevant medical history. All court records are sealed. Patients may choose closed adoption for more privacy.


  • There is no updated central database on adoption and available data are limited.
  • Of U.S. infant adoptions, 59% occur through the child welfare system, 26% involve children born internationally, and 15% involve U.S.-born infants placed (Arons 2010).
  • The proportion of infants placed for U.S. adoption declined from nearly 10% before 1973 (the year Roe v. Wade was decided) to 1% by 2002 (Jones 2009).
  • Patients choosing to place a child for adoption are more likely to be never married, young, higher income and more educated than those choosing parenting (Arons 2010).
  • Of U.S. reproductive aged women, < 1% (0.7%) has ever adopted a child (Ugwu 2015)
  • Adoptive parents are more likely to be > 35, ever married, to have previously used infertility services, or to be men, than people who have not adopted (Jones 2009).
  • Patients who have ever used infertility services are 10 times more likely to have adopted than those who have never used infertility services (Jones 2009).
  • The Hague Convention on Protection of Children was introduced in 1993 as an international treaty providing safeguards to protect the best interests of children, birth parents, and adoptive parents involved in intercountry adoptions.
  • The rates of intercountry adoptions have decreased in the last 2 decades, and countries participating continue to change. 


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