In many jurisdictions the adopted person's full original birth certificate is cancelled and replaced with a fabricated post-adoption birth certificate which states that the child was born to the adoptive parents. This deception, when carried out, may continue with the adopted person for life and can be the cause for many well documented traumas experienced by the adopted person, including loss of identity, family history, culture, biological family (including not only biological parents but also siblings and extended family), family medical history and records, and increased risk of suicide, homelessness, incarceration, PTSD, depression, and anxiety.

More recent research found that in a sample of mothers who had released their children for adoption four to 12 years prior, every participant had frequent thoughts of their lost child. For most, thoughts were both negative and positive in that they produced both feelings of sadness and joy. Those who experienced the greatest portion of positive thoughts were those who had open, rather than closed or time-limited mediated adoptions.[123]


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United States approx 136,000 (2008)[69] 3,978,500 (2015)[70] ≈3 per 100 live births The number of adoptions is reported to be constant since 1987. Since 2000, adoption by type has generally been approximately 15% international adoptions, 40% from government agencies responsible for child welfare, and 45% other, such as voluntary adoptions through private adoption agencies or by stepparents and other family members.[69]
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The period 1945 to 1974, the baby scoop era, saw rapid growth and acceptance of adoption as a means to build a family.[40] Illegitimate births rose three-fold after World War II, as sexual mores changed. Simultaneously, the scientific community began to stress the dominance of nurture over genetics, chipping away at eugenic stigmas.[41][42] In this environment, adoption became the obvious solution for both unwed people and infertile couples.[43]
Several factors affect the decision to release or raise the child. White adolescents tend to give up their babies to non-relatives, whereas black adolescents are more likely to receive support from their own community in raising the child and also in the form of informal adoption by relatives.[118] Studies by Leynes and by Festinger and Young, Berkman, and Rehr found that for pregnant adolescents, the decision to release the child for adoption depended on the attitude toward adoption held by the adolescent's mother.[119] Another study found that pregnant adolescents whose mothers had a higher level of education were more likely to release their babies for adoption. Research suggests that women who choose to release their babies for adoption are more likely to be younger, enrolled in school, and have lived in a two-parent household at age 10, than those who kept and raised their babies.[120] 

Unlike guardianship or other systems designed for the care of the young, adoption is intended to effect a permanent change in status and as such requires societal recognition, either through legal or religious sanction. Historically, some societies have enacted specific laws governing adoption; where others have tried to achieve adoption through less formal means, notably via contracts that specified inheritance rights and parental responsibilities without an accompanying transfer of filiation. Modern systems of adoption, arising in the 20th century, tend to be governed by comprehensive statutes and regulations.
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