For many years in New York State, adoptees had to obtain the permission of their adoptive parents (unless deceased) to be included in a state-sponsored reunion registry regardless of the age of the adoptee. In some cases, older adults or even senior citizens felt like they were being treated like children, and required to obtain their parents' signature on the form. In a broader sense, they felt it could be inferred that adopted children are always children, and thus second-class citizens subject to discrimination. The law has since been changed.
Although practices vary state by state, most adoptions start with the birth mother reviewing dozens of adoption profile books  or online profiles of prospective adoptive parents. Usually, these are adoptive families who have retained that agency or attorney to assist them in the adoption process. Most US states permit full openness not just regarding identities, but also personal information about each other. Just as the adoptive parents want to learn about the birth mother's life and health history, so does the birth mother want the same information about the people she is considering as the parents for her child.
Many adopting parents in non-private adoptions would apply to a local, state licensed adoption agency. The agency may be a member of the national Child Welfare League of America (CWLA). The CWLA and many adoption agencies are still in operation today, but with an expanded and somewhat different agenda compared to past decades, as the government has largely taken over some of their previous responsibilities.
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Some states have confidential intermediary systems. This often requires a person to petition the court to view the sealed adoption records, then the intermediary conducts a search similar to that of a private investigator. This can be either a search for the birth mother at the request of the adoptee, or vice versa. Quite often, in the many years which have passed since the adoptee was born, a birth mother or female adoptee has both moved to another address, and married or remarried resulting in a change of her surname. While this can make the search difficult and time consuming, a marriage certificate may provide the needed clue as to the person's whereabouts. If and when the intermediary is able to contact the birth mother (or adoptee), she is informed that her adopted child (or birth mother) is inquiring about her. In the few states that have open adoption records, should this party indicate that he or she does not want to be contacted, by law, the information would not be given out. Upon completion of the search in which the birth mother agrees to be contacted, the intermediary usually sends the adoptee the official unamended birth certificate obtained from the court. The adoptive parents' application to an adoption agency remains confidential, however.
In a closed adoption, the adoption professionals involved will usually choose the adoptive family for the child. It is important to remember that having a closed adoption does not guarantee that once a child reaches the age of majority in your state he or she will not seek out and reunite with their biological families or that the biological family will not seek and reunite with the child that was adopted. The closed or open adoption agreements made between the parties of an adoption at the time of the child's birth only stay in force until the child reaches the legal age in which he or she can make decisions for his or her own self.
Many birth mothers do more than just meet the adoptive parents once before the birth. If they live close enough to each other it is not uncommon for the birth mother to invite the adoptive mother (or adoptive father too if the birth mother wishes) to come to her doctor appointments. This may allow all parties to the adoption a chance to bond. Adoptive parents may be present for the delivery if that is the birth mother's wish.
The social stigma of unmarried mothers, particularly during the Baby Scoop Era (1945-1975) rendered them social outcasts. By the 1980s the situation improved greatly and the vast majority of unwed mothers kept their babies. In a mother driven society after WWII infertile couples were also seen as deviant due to their inability to bear children. The social experiment of taking the children from "unmarried mothers" and "giving them" to adoptive parents became the norm during the BSE. These adoptions were predominantly closed. The records were sealed, biological mothers were told to keep their child a secret, and adoptive parents told to treat the child "as if born to".