Before the 1980s, most adoptions were kept closed. This is because women who go through unexpected pregnancy simply relocate while pregnant, give birth and then return to their homes. The doctor or an agency then looks for an adoptive family for the child without the mother knowing. This kind of setup can bring about a lot of complications and confusion within the adoptive family, particularly on the adopted child.
All states allow an adoptive parents access to non-identifying information of an adoptee who is still a minor. Nearly all states allow the adoptee, upon reaching adulthood, access to non-identifying information about their relatives. Approximately 27 states allow biological parents access to non-identifying information. In addition many states give such access to adult siblings. Identifying information is any data that may lead to the positive identification of an adoptee, biological parents, or other relatives. Nearly all states permit the release of identifying information when the person whose information is sought has consented to the release. Many states ask biological parents to specify at the time of consent or surrender whether they are willing to have their identity disclosed to the adoptee when he or she is age 18 or 21.5. If consent is not on file, the information may not be released without a court order documenting good cause to release the information. A person seeking a court order must be able to demonstrate by clear and convincing evidence that there is a compelling reason for disclosure that outweighs maintaining the confidentiality of a party to an adoption. In Alabama, Alaska, Delaware, Kansas, New Hampshire, and Oregon, there is no requirement to document good cause in order to access their birth certificates. Some groups, such as Bastard Nation, One Voice, and Origins USA, campaign for adoptees' automatic access to birth certificates in other US states.
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.
Open adoption is a form of adoption in which the biological and adoptive families have access to varying degrees of each other's personal information and have an option of contact. While open adoption is a relatively new phenomenon in the west, it has been a traditional practice in many Asian societies, especially in South Asia, for many centuries. In Hindu society, for example, it is relatively common for a childless couple to adopt the second or later son of the husband's brother when the childless couple has limited hope of producing their own child.