Reform and family preservation efforts have also been strongly associated with the perceived misuse of adoption. In some cases, parents' rights have been terminated when their ethnic or socio-economic group has been deemed unfit by society. Some of these practices were generally accepted but have later been considered abusive; others were uncontroversially reprehensible.

Embryo adoption: based on the donation of embryos remaining after one couple's in vitro fertilization treatments have been completed; embryos are given to another individual or couple, followed by the placement of those embryos into the recipient woman's uterus, to facilitate pregnancy and childbirth. In the United States, embryo adoption is governed by property law rather than by the court systems, in contrast to traditional adoption.
Ad hoc studies, performed in the U.S., however, suggest that between 10 and 25 percent of adoptions through the child welfare system (e.g., excluding babies adopted from other countries or stepparents adopting their stepchildren) disrupt before they are legally finalized and from 1 to 10 percent are dissolved after legal finalization. The wide range of values reflects the paucity of information on the subject and demographic factors such as age; it is known that teenagers are more prone to having their adoptions disrupted than young children.[91]
These practices have become significant social and political issues in recent years, and in many cases the policies have changed.[176][177] The United States, for example, now has the 1978 Indian Child Welfare Act, which allows the tribe and family of a Native American child to be involved in adoption decisions, with preference being given to adoption within the child's tribe.[178]

Although adoption is today practiced globally, the United States has the largest number of children adopted per 100 live births. The table below provides a snapshot of Western adoption rates. Adoption in the United States still occurs at nearly three times those of its peers although the number of children awaiting adoption has held steady in recent years, hovering between 133,000 and 129,000 during the period 2002 to 2006.[52]

There are supporters of various lists, developed over many decades, and there are persons who find them lacking, created to support an agenda, or furthering division. All terminology can be used to demean or diminish, uplift or embrace. In addressing the linguistic problem of naming, Edna Andrews says that using "inclusive" and "neutral" language is based upon the concept that "language represents thought, and may even control thought."[190]

As the idea of institutional care gained acceptance, formal rules appeared about how to place children into families: boys could become apprenticed to an artisan and girls might be married off under the institution's authority.[19] Institutions informally adopted out children as well, a mechanism treated as a way to obtain cheap labor, demonstrated by the fact that when the adopted died, their bodies were returned by the family to the institution for burial.[20]
Europe's cultural makeover marked a period of significant innovation for adoption. Without support from the nobility, the practice gradually shifted toward abandoned children. Abandonment levels rose with the fall of the empire and many of the foundlings were left on the doorstep of the Church.[18] Initially, the clergy reacted by drafting rules to govern the exposing, selling, and rearing of abandoned children. The Church's innovation, however, was the practice of oblation, whereby children were dedicated to lay life within monastic institutions and reared within a monastery. This created the first system in European history in which abandoned children did not have legal, social, or moral disadvantages. As a result, many of Europe's abandoned and orphaned children became alumni of the Church, which in turn took the role of adopter. Oblation marks the beginning of a shift toward institutionalization, eventually bringing about the establishment of the foundling hospital and orphanage.[18]

Psychologists' findings regarding the importance of early mother-infant bonding created some concern about whether parents who adopt older infants or toddlers after birth have missed some crucial period for the child's development. However, research on The Mental and Social Life of Babies suggested that the "parent-infant system," rather than a bond between biologically related individuals, is an evolved fit between innate behavior patterns of all human infants and equally evolved responses of human adults to those infant behaviors. Thus nature "ensures some initial flexibility with respect to the particular adults who take on the parental role."[96]