By 1979, representatives of 32 organizations from 33 states, Canada and Mexico gathered in Washington, DC to establish the American Adoption Congress (AAC) passing a unanimous resolution: "Open Records complete with all identifying information for all members of the adoption triad, birthparents, adoptive parents and adoptee at the adoptee's age of majority (18 or 19, depending on state) or earlier if all members of the triad agree."[161] Later years saw the evolution of more militant organizations such as Bastard Nation (founded in 1996), groups that helped overturn sealed records in Alabama, Delaware, New Hampshire, Oregon, Tennessee, and Maine.[162][163] Simultaneously, groups such as Origins USA (founded in 1997) started to actively speak about family preservation and the rights of mothers.[164] The intellectual tone of these recent reform movements was influenced by the publishing of The Primal Wound by Nancy Verrier. "Primal wound" is described as the "devastation which the infant feels because of separation from its birth mother. It is the deep and consequential feeling of abandonment which the baby adoptee feels after the adoption and which may continue for the rest of his life."[153]
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]

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]


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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]
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]
Now it happens that some people are interested in the welfare and high development of the human race; but leaving aside those exceptional people, all fathers and mothers are interested in the welfare of their own families. The dearest thing to the parental heart is to have the children marry well and rear a noble family. How short-sighted it is then for such a family to take into its midst a child whose pedigree is absolutely unknown; or, where, if it were partially known, the probabilities are strong that it would show poor and diseased stock, and that if a marriage should take place between that individual and any member of the family the offspring would be degenerates.[39]
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.
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]

In Spain under Francisco Franco’s 1939–75 dictatorship the newborns of some left-wing opponents of the regime, or unmarried or poor couples, were removed from their mothers and adopted. New mothers were frequently told their babies had died suddenly after birth and the hospital had taken care of their burials, when in fact they were given or sold to another family. It is believed that up to 300,000 babies were involved. These system – which allegedly involved doctors, nurses, nuns and priests – outlived Franco’s death in 1975 and carried on as an illegal baby trafficking network until 1987 when a new law regulating adoption was introduced.[180][181]
Other ancient civilizations, notably India and China, used some form of adoption as well. Evidence suggests the goal of this practice was to ensure the continuity of cultural and religious practices; in contrast to the Western idea of extending family lines. In ancient India, secondary sonship, clearly denounced by the Rigveda,[12] continued, in a limited and highly ritualistic form, so that an adopter might have the necessary funerary rites performed by a son.[13] China had a similar idea of adoption with males adopted solely to perform the duties of ancestor worship.[14]
In Spain under Francisco Franco’s 1939–75 dictatorship the newborns of some left-wing opponents of the regime, or unmarried or poor couples, were removed from their mothers and adopted. New mothers were frequently told their babies had died suddenly after birth and the hospital had taken care of their burials, when in fact they were given or sold to another family. It is believed that up to 300,000 babies were involved. These system – which allegedly involved doctors, nurses, nuns and priests – outlived Franco’s death in 1975 and carried on as an illegal baby trafficking network until 1987 when a new law regulating adoption was introduced.[180][181]

In sum, reunions can bring a variety of issues for adoptees and parents. Nevertheless, most reunion results appear to be positive. In the largest study to date (based on the responses of 1,007 adoptees and relinquishing parents), 90% responded that reunion was a beneficial experience. This does not, however, imply ongoing relationships were formed between adoptee and parent nor that this was the goal.[170]
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"[182][183] occurred. Along with the change in times and social attitudes came additional examination of the language used in adoption.
"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."
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.[79] 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%.[80][81] 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.[82]
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]

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.[79] 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%.[80][81] 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.[82]
Some adoptees reject the idea of reunion. It is unclear, though, what differentiates adoptees who search from those who do not. One paper summarizes the research, stating, "...attempts to draw distinctions between the searcher and non-searcher are no more conclusive or generalizable than attempts to substantiate...differences between adoptees and nonadoptees."[169]
Evidence about the development of adoptees can be supported in newer studies. It can be said that adoptees, in some respect, tend to develop differently from the general population. This can be seen in many aspects of life, but usually can be found as a greater risk around the time of adolescence. For example, it has been found that many adoptees experience difficulty in establishing a sense of identity.[126]

Other ancient civilizations, notably India and China, used some form of adoption as well. Evidence suggests the goal of this practice was to ensure the continuity of cultural and religious practices; in contrast to the Western idea of extending family lines. In ancient India, secondary sonship, clearly denounced by the Rigveda,[12] continued, in a limited and highly ritualistic form, so that an adopter might have the necessary funerary rites performed by a son.[13] China had a similar idea of adoption with males adopted solely to perform the duties of ancestor worship.[14]

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]
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]
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"[182][183] occurred. Along with the change in times and social attitudes came additional examination of the language used in adoption.
During the same period, the Progressive movement swept the United States with a critical goal of ending the prevailing orphanage system. The culmination of such efforts came with the First White House Conference on the Care of Dependent Children called by President Theodore Roosevelt in 1909,[33] where it was declared that the nuclear family represented "the highest and finest product of civilization" and was best able to serve as primary caretaker for the abandoned and orphaned.[34][35] Anti-institutional forces gathered momentum. As late as 1923, only two percent of children without parental care were in adoptive homes, with the balance in foster arrangements and orphanages. Less than forty years later, nearly one-third were in an adoptive home.[36]

The most recent adoption attitudes survey completed by the Evan Donaldson Institute provides further evidence of this stigma. Nearly one-third of the surveyed population believed adoptees are less-well adjusted, more prone to medical issues, and predisposed to drug and alcohol problems. Additionally, 40–45% thought adoptees were more likely to have behavior problems and trouble at school. In contrast, the same study indicated adoptive parents were viewed favorably, with nearly 90% describing them as "lucky, advantaged, and unselfish."[144]
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