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Open adoption is now the most widely practiced form of adoption in the United States. In an open adoption, identifying information is shared, including names, phone numbers, and email addresses. Additionally, an open adoption includes varying degrees of openness after the adoption process is finalized. This typically includes the exchange of emails, letters, pictures, and phone calls. A fully open adoption also includes in-person visits. Fully open adoptions can also include extended family members, such as birthgrandparents and siblings.
Prior to adoption, the infant would often be placed in temporary and state-mandated foster care for a few weeks to several months until the adoption was approved. This would also help ensure that he or she was healthy, that the birthparent was sure about relinquishment, and that nothing was overlooked at the time of birth. Nowadays[when?], this practice is discouraged, as it prevents immediate bonding between the mother and child. Also, much better medical testing is available, both prenatally and postnatally. Many children also developed orphanage-type behavior including head banging, rocking and hand flapping. Many adopted adults still retain this rocking behavior especially when tired.
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.
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Now that the first open-adoption generation is under way, social workers are becoming more aware of the role of siblings in these arrangements. An adoptive child’s relationships with biological siblings need to be taken into account. And two children adopted into the same family may have different degrees of openness with their birth mothers. Openness may also affect decisions about family size.
A 1996 study reported in Child Development found that all the children studied “reported positive levels of self-esteem, curiosity about their birthparents, and satisfaction with the openness situation” regardless of whether their adoptions were closed, semi-open, or open. What this seems to mean is that the child's sense of security in his adoptive family is more important than contact with the birth family.