Although practices vary state by state, most adoptions start with the birth mother reviewing dozens of adoption profile books [11] 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.[12]

Open adoption has slowly become more common since research in the 1970s suggested that open adoption was better for children. In 1975 the tide began to change, and by the early 1990s open adoptions were offered by a majority of American adoption agencies.[3][4][5] Especially rapid progress was seen in the late 1980s and early 1990s - between 1987 and 1989 a study found only a third of agencies offered fully open adoption as an option; by 1993 76 percent of the surveyed agencies offered fully open adoptions.[citation needed] As of 2013, roughly half of US states consider them legally binding,[6] however contact in open adoption is not always maintained.
Decades ago, virtually all adoptions were closed. A closed adoption means that there is no contact whatsoever between the birthparents and the adoptive parents and child after the adoption takes place. In fact, there may also be no contact before the adoption. Nowadays, however, the trend in the United States is toward open adoptions, in which all the parties to an adoption meet and often remain in each other's lives.
It’s important to keep in mind that, while adoption relationships can change, it is more complicated to increase contact than to decrease it. If a birth mother starts with an open relationship and then decides later that she needs distance, she can do this at any time. However, if an adoption is closed and a birth mother wants more contact, then she has to come to an agreement with the adoptive family. Therefore, it is especially important that a birth mother choosing closed adoption is sure that it is what she wants.
Another way older children can be placed for adoption is where the birth parents' rights were terminated by a court due to improper parenting or abuse. Although the child may still foster idealized feelings for that failing parent it is not uncommon in these adoptions for there to be no contact between the child and adoptive parent, and the birth parent.

The placement of older children can take two widely divergent paths. Generally speaking when a child has bonded to a birth parent then a need for an adoptive placement arises, it is usually critical for that child's emotional welfare to maintain ties with the birth parent. Sometimes a parent raised a child, but a problem has arisen, and parenting is no longer possible, and there are no family members able to take over the parenting role, so adoption is the best option.[23]
Closed adoption may be beneficial in allowing a child to live a life without fear that he or she will be found by anyone who has caused harm in the past. Especially in cases where a child has been placed with a family through the foster care system, it may be necessary and provide the benefit of safety and security for the child. If the child was placed because of abuse, a closed adoption would allow for the adoptive family to feel safe and for their child to not worry about his or her well-being.
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.
There are also private search companies and investigators who charge fees to do a search for or assist adoptees and birth mothers and fathers locate each other, as well as to help other types of people searching. These services typically cost much more, but like search organizations and search angels, have far greater flexibility in regards to releasing information, and typically provide their own intermediary services. However, they may not circumvent the law regarding the confidentiality process.
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