The number of adoptions in the United States peaked in 1970.[45] It is uncertain what caused the subsequent decline. Likely contributing factors in the 1960s and 1970s include a decline in the fertility rate, associated with the introduction of the pill, the completion of legalization of artificial birth control methods, the introduction of federal funding to make family planning services available to the young and low income, and the legalization of abortion. In addition, the years of the late 1960s and early 1970s saw a dramatic change in society's view of illegitimacy and in the legal rights[46] of those born outside of wedlock. In response, family preservation efforts grew[47] so that few children born out of wedlock today are adopted. Ironically, adoption is far more visible and discussed in society today, yet it is less common.[48]


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Who are the children who wait? The children who wait are the survivors of abuse and neglect. They are school aged children, siblings, children of color and children with disabilities. Each of them waits for adoption and there are more than 114,000 of them across the country. These children live in a series of foster and group homes for an average of three years. There they wait while they hope for the stability of an adoptive family.
Nevertheless, some indication of the level of search interest by adoptees can be gleaned from the case of England and Wales which opened adoptees' birth records in 1975. The UK Office for National Statistics has projected that 33% of all adoptees would eventually request a copy of their original birth records, exceeding original forecasts made in 1975 when it was believed that only a small fraction of the adoptee population would request their records. The projection is known to underestimate the true search rate, however, since many adoptees of the era get their birth records by other means.[166]
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.

Identity is defined both by what one is and what one is not. Adoptees born into one family lose an identity and then borrow one from the adopting family. The formation of identity is a complicated process and there are many factors that affect its outcome. From a perspective of looking at issues in adoption circumstances, the people involved and affected by adoption (the biological parent, the adoptive parent and the adoptee) can be known as the "triad members and state". Adoption may threaten triad members' sense of identity. Triad members often express feelings related to confused identity and identity crises because of differences between the triad relationships. Adoption, for some, precludes a complete or integrated sense of self. Triad members may experience themselves as incomplete, deficient, or unfinished. They state that they lack feelings of well-being, integration, or solidity associated with a fully developed identity.[129]
Nevertheless, work on adult adoptees has found that the additional risks faced by adoptees are largely confined to adolescence. Young adult adoptees were shown to be alike with adults from biological families and scored better than adults raised in alternative family types including single parent and step-families.[137] Moreover, while adult adoptees showed more variability than their non-adopted peers on a range of psychosocial measures, adult adoptees exhibited more similarities than differences with adults who had not been adopted.[138] There have been many cases of remediation or the reversibility of early trauma. For example, in one of the earliest studies conducted, Professor Goldfarb in England concluded that some children adjust well socially and emotionally despite their negative experiences of institutional deprivation in early childhood.[139] Other researchers also found that prolonged institutionalization does not necessarily lead to emotional problems or character defects in all children. This suggests that there will always be some children who fare well, who are resilient, regardless of their experiences in early childhood.[140] Furthermore, much of the research on psychological outcomes for adoptees draws from clinical populations. This suggests that conclusions such that adoptees are more likely to have behavioral problems such as ODD and ADHD may be biased. Since the proportion of adoptees that seek mental health treatment is small, psychological outcomes for adoptees compared to those for the general population are more similar than some researchers propose.[141]
The adoptee population does, however, seem to be more at risk for certain behavioral issues. Researchers from the University of Minnesota studied adolescents who had been adopted and found that adoptees were twice as likely as non-adopted people to suffer from oppositional defiant disorder and attention-deficit/hyperactivity disorder (with an 8% rate in the general population).[135] Suicide risks were also significantly greater than the general population. Swedish researchers found both international and domestic adoptees undertook suicide at much higher rates than non-adopted peers; with international adoptees and female international adoptees, in particular, at highest risk.[136]
His solution was outlined in The Best Method of Disposing of Our Pauper and Vagrant Children (1859) which started the Orphan Train movement. The orphan trains eventually shipped an estimated 200,000 children from the urban centers of the East to the nation's rural regions.[28] The children were generally indentured, rather than adopted, to families who took them in.[29] As in times past, some children were raised as members of the family while others were used as farm laborers and household servants.[30] The sheer size of the displacement—the largest migration of children in history—and the degree of exploitation that occurred, gave rise to new agencies and a series of laws that promoted adoption arrangements rather than indenture. The hallmark of the period is Minnesota's adoption law of 1917 which mandated investigation of all placements and limited record access to those involved in the adoption.[31][32]
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.
"Honest Adoption Language" refers to a set of terms that proponents say reflect the point of view that: (1) family relationships (social, emotional, psychological or physical) that existed prior to the legal adoption often continue past this point or endure in some form despite long periods of separation, and that (2) mothers who have "voluntarily surrendered" children to adoption (as opposed to involuntary terminations through court-authorized child-welfare proceedings) seldom view it as a choice that was freely made, but instead describe scenarios of powerlessness, lack of resources, and overall lack of choice.[187][188] It also reflects the point of view that the term "birth mother" is derogatory in implying that the woman has ceased being a mother after the physical act of giving birth. Proponents of HAL liken this to the mother being treated as a "breeder" or "incubator".[189] Terms included in HAL include terms that were used before PAL, including "natural mother," "first mother," and "surrendered for adoption."
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]
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