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.[citation needed]

Oftentimes the birth and adoptive parents will sign a Post-Adoption Contract (sometimes called an Open Adoption Agreement), putting in writing any promises regarding contact after the adoption is finalized. Even in those states which do not expressly have laws in this area, these agreements can usually be prepared if the parties desire to formalize the agreement. In an increasing number of US states, courts will find these agreements legally enforceable, as long as they serve the best interests of the child. It is not unusual for these agreements to be more like "handshake" agreements, although they offer less protection to a birth parent if the adoptive parent's promises were not honored.[22]
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The empty mailbox is just one example of the challenges that families in open adoptions may face. In recent years, we have embraced the concept of open adoption with gusto — yet the journey, for some, has proved to be unexpectedly bumpy. Lack of support, a sudden change in the life of either the adoptive or biological family, logistical pressures — all can complicate matters. Add to that the emotionally charged issues at stake-parenthood, power, identity — and open adoption can make for some combustible family dynamics.
We have learned valuable lessons regarding the resilience of children, and they continue to astound and inspire us. We have also been humbled by many birth parents who have been able to successfully resolve the grief of lost opportunities to parent their children through sheer grace that is involved in their healing relationships with their children and their adoptive family members through the years.

At present, most adoption agencies let the birth mother decide on most of the terms of the adoption, including how much interaction she wants to maintain with the child and adoptive parents. The agency then looks for the suitable adoptive family that will adhere to the birth mother’s wishes. Even so, there are still some birth parents who prefer closed adoptions and deny contact or exchange of identifying information.
Reunion registries were designed so adoptees and their birth parents, siblings or other family members can locate one another at little or no cost. In these mutual consent registries, both parties must have registered in order for there to be a match. Most require the adoptee to be at least 18 years old. Though they did not exist until late in the 20th century, today there are many World Wide Web pages, chat rooms, and other online resources that offer search information, registration and support.
Whether you are seeking to adopt or considering placing your child for adoption, it is a good idea to decide whether open adoption is the right choice for you and your child. Today, it is increasingly common for birth parents and adoptive parents to communicate directly with one another before, during, and after the adoption process is complete. That contact can take place in many different ways including through the exchange of emails, letters, phone calls, Skype calls, and in-person visits.
Adoptive parents may be less likely to consider the possibility that they are doing something wrong, and blame the child's heredity. The parents may even unfavorably compare their adopted child with a near-perfect, genetically-related "fantasy" child. This enables them to blame ordinary problems which all parents face on their child's supposedly "defective" genes. Thus, while non-adoptive parents are focused on nurture, some adoptive parents are solely focused on nature (i.e. heredity) instead. This results in what could have been an easily resolved problem, going unresolved in families with adopted children, possibly accompanied by child abuse.[5]
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).[2] 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.

“It removes the mystery, but it doesn’t remove the grief,” said Claude Riedel, a psychologist and family therapist who co-directs the Adoptive Family Counseling Center in Minnesota. “The reality is that, at certain stages, it’s normal to have questions: why did you choose not to parent me, not to keep me? And there may be complexities: have you kept your other children, but not me?”

At present, most adoption agencies let the birth mother decide on most of the terms of the adoption, including how much interaction she wants to maintain with the child and adoptive parents. The agency then looks for the suitable adoptive family that will adhere to the birth mother’s wishes. Even so, there are still some birth parents who prefer closed adoptions and deny contact or exchange of identifying information.
These are just some of the possible scenarios that fall under an open adoption. For older children and teen adoptees, their adoptions are almost always open because they already have spent a good deal of their life with their birth parents. Therefore, they most likely will have some sort of identifying information about their birth parents or other members of their family, such as their siblings who might have been placed separately.
Over the past few decades, we’ve found that the majority of prospective birth mothers are looking for an adoptive family they can have a personal relationship with before, during and after the adoption process is complete. Therefore, we require our prospective adoptive families to be open to the kind of communication most of these birth mothers are looking for, including:
The probate laws of most states in the U.S. prohibit an adoptee from automatically inheriting from his or her birth parents. This applies regardless of whether or not the birth father participated in or agreed to the adoption. Had the adoption not have taken place, any son or daughter would be an heir upon his or her father's death—regardless of who his childhood caretakers were. There can be additional complications if the birth father has subsequently moved to another state. Should a birth parent include an "unknown" adoptee in his or her will, the probate court has no obligation to fulfill this type of request, while "known" adoptees may have the same status as non-family members. However, there is some variation in probate laws from one state to another.
These are just some of the possible scenarios that fall under an open adoption. For older children and teen adoptees, their adoptions are almost always open because they already have spent a good deal of their life with their birth parents. Therefore, they most likely will have some sort of identifying information about their birth parents or other members of their family, such as their siblings who might have been placed separately.
Like any relationship, open adoption relationships evolve over time. Post-adoption contact may increase or decrease, or the nature of the contact may change along with people’s changing lives. However, even in the most open adoption relationship, the birth parent is not a co-parent but rather another very important person in the child’s life. The child’s adoptive parent(s) are his or her legal parent(s) and they have all rights and responsibility for the child. Most importantly, when birth parents and adoptive parents set out to forge their relationship, the child’s needs must always be paramount. 

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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