Infertility is the main reason parents seek to adopt children they are not related to. One study shows this accounted for 80% of unrelated infant adoptions and half of adoptions through foster care. Estimates suggest that 11–24% of Americans who cannot conceive or carry to term attempt to build a family through adoption, and that the overall rate of ever-married American women who adopt is about 1.4%. Other reasons people adopt are numerous although not well documented. These may include wanting to cement a new family following divorce or death of one parent, compassion motivated by religious or philosophical conviction, to avoid contributing to overpopulation out of the belief that it is more responsible to care for otherwise parent-less children than to reproduce, to ensure that inheritable diseases (e.g., Tay–Sachs disease) are not passed on, and health concerns relating to pregnancy and childbirth. Although there are a range of possible reasons, the most recent study of experiences of women who adopt suggests they are most likely to be 40–44 years of age, currently married, have impaired fertility, and childless.
In the 1970s, as adoption search and support organizations developed, there were challenges to the language in common use at the time. As books like Adoption Triangle by Sorosky, Pannor and Baran were published, and support groups formed like CUB (Concerned United Birthparents), a major shift from "natural parent" to "birthparent" occurred. Along with the change in times and social attitudes came additional examination of the language used in adoption.
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The practice of closed adoption (aka confidential or secret adoption), which has not been the norm for most of modern history, seals all identifying information, maintaining it as secret and preventing disclosure of the adoptive parents', biological kins', and adoptees' identities. Nevertheless, closed adoption may allow the transmittal of non-identifying information such as medical history and religious and ethnic background. Today, as a result of safe haven laws passed by some U.S. states, secret adoption is seeing renewed influence. In so-called "safe-haven" states, infants can be left, anonymously, at hospitals, fire departments, or police stations within a few days of birth, a practice criticized by some adoption advocacy organizations as being retrograde and dangerous.
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. 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.
Family preservation: As concerns over illegitimacy began to decline in the early 1970s, social-welfare agencies began to emphasize that, if possible, mothers and children should be kept together. In the U.S., this was clearly illustrated by the shift in policy of the New York Foundling Home, an adoption-institution that is among the country's oldest and one that had pioneered sealed records. It established three new principles including "to prevent placements of children...," reflecting the belief that children would be better served by staying with their biological families, a striking shift in policy that remains in force today.
Markedly different from the modern period, ancient adoption practices put emphasis on the political and economic interests of the adopter, providing a legal tool that strengthened political ties between wealthy families and created male heirs to manage estates. The use of adoption by the aristocracy is well documented; many of Rome's emperors were adopted sons. Adrogation was a kind of Roman adoption which required the adrogator to be at least 60 years old.
The stigmas associated with adoption are amplified for children in foster care. Negative perceptions result in the belief that such children are so troubled it would be impossible to adopt them and create "normal" families. A 2004 report from the Pew Commission on Children in Foster Care has shown that the number of children waiting in foster care doubled since the 1980s and now remains steady at about a half-million a year."