"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."
The nobility of the Germanic, Celtic, and Slavic cultures that dominated Europe after the decline of the Roman Empire denounced the practice of adoption.[15] In medieval society, bloodlines were paramount; a ruling dynasty lacking a "natural-born" heir apparent was replaced, a stark contrast to Roman traditions. The evolution of European law reflects this aversion to adoption. English Common Law, for instance, did not permit adoption since it contradicted the customary rules of inheritance. In the same vein, France's Napoleonic Code made adoption difficult, requiring adopters to be over the age of 50, sterile, older than the adopted person by at least 15 years, and to have fostered the adoptee for at least six years.[16] Some adoptions continued to occur, however, but became informal, based on ad hoc contracts. For example, in the year 737, in a charter from the town of Lucca, three adoptees were made heirs to an estate. Like other contemporary arrangements, the agreement stressed the responsibility of the adopted rather than adopter, focusing on the fact that, under the contract, the adoptive father was meant to be cared for in his old age; an idea that is similar to the conceptions of adoption under Roman law.[17]
Attitudes and laws regarding adoption vary greatly. Whereas all cultures make arrangements whereby children whose birth parents are unavailable to rear them can be brought up by others, not all cultures have the concept of adoption, that is treating unrelated children as equivalent to biological children of the adoptive parents. Under Islamic Law, for example, adopted children must keep their original surname to be identified with blood relations,[194] and, traditionally, women wear a hijab in the presence of males in their adoptive households. In Egypt, these cultural distinctions have led to making adoption illegal.[195]
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] 

Social workers and other professionals in the field of adoption began changing terms of use to reflect what was being expressed by the parties involved. In 1979, Marietta Spencer wrote "The Terminology of Adoption" for The Child Welfare League of America (CWLA),[184] which was the basis for her later work "Constructive Adoption Terminology".[185] This influenced Pat Johnston's "Positive Adoption Language" (PAL) and "Respectful Adoption Language" (RAL).[186] The terms contained in "Positive Adoption Language" include the terms "birth mother" (to replace the terms "natural mother" and "real mother"), and "placing" (to replace the term "surrender"). These kinds of recommendations encouraged people to be more aware of their use of adoption terminology.
In another study that compared mothers who released their children to those who raised them, mothers who released their children were more likely to delay their next pregnancy, to delay marriage, and to complete job training. However, both groups reached lower levels of education than their peers who were never pregnant.[124] Another study found similar consequences for choosing to release a child for adoption. Adolescent mothers who released their children were more likely to reach a higher level of education and to be employed than those who kept their children. They also waited longer before having their next child.[122] Most of the research that exists on adoption effects on the birth parents was conducted with samples of adolescents, or with women who were adolescents when carrying their babies—little data exists for birth parents from other populations. Furthermore, there is a lack of longitudinal data that may elucidate long-term social and psychological consequences for birth parents who choose to place their children for adoption.

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.
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]
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]