How Adoption Works

It's important to make sure that your adopted child will have adequate space to live, play and grow.
Photo courtesy © Michael Bretherton

Tens of thousands of children are adopted in the United States each year. Adoption gives children an opportunity for a new beginning in a supportive and loving environment. But how does adoption work? Who is allowed to adopt, and why does it cost money? In this article, we’ll look at how adoption works, including domestic adoption, foster care and intercountry adoption. We’ll also explain how to prepare for adoption and what post-adoption services you should consider.

Adoption is a lifelong process, one that requires a lot of preparation and dedication. Adopted children generally do very well in their new families, but problems can arise with adjustment, dealing with parents, coming to terms with a new and unfamiliar situation and interactions between different ethnicities and cultures. In preparing for adoption, it’s essential to be educated about the process and about the challenges you and your child may face. Adoption agencies, colleges, hospitals, religious groups and other organizations provide adoption preparation programs. There are also numerous books, magazines and Web sites about adoption. You can contact friends or relatives who have adopted children or who were adopted themselves, and ask them about their experiences. Consider joining an adoption support group or contacting one to see if they have information or services to offer.


Whether adopting as a single parent or with a spouse, it’s important to ask yourself why you want to adopt. Are you prepared to provide for the needs of a child until he or she reaches adulthood? Is your marriage stable enough to handle the new addition to your family? Some couples believe that adopting a child can somehow heal a fractured marriage, but introducing a child into such a situation is unfair to the child -- who is possibly coming from a broken family of his own -- and will divert attention from a marriage’s real problems.

Familiarize yourself with state and federal adoption laws. In particular, research laws governing who can adopt, timeframes for consent and revocation of consent and termination of parental rights laws.

In preparing for adoption, look at your home and consider where your child will live and whether any renovations or safety precautions need to be implemented. Adoption agencies aren’t looking for “perfect” or wealthy families. Rather, they are looking for families who can provide a loving, welcome and supportive environment that also accommodates any special needs an adopted child may have.

After prepa­ring for adoption, the most important consideration to make is what kind of adoption do you want to pursue -- foster care, domestic, intercountry -- and what kind of agency will you need. In the next section, we’ll look at how to choose an adoption agency.




Choosing an Adoption Agency

An adoption agency can help you with an intercountry adoption.
Photo courtesy stock.xchng


It is possible to adopt without using an adoption agency. However, adoption agenci­es provide many valuable services, and in some cases, the assistance of an adoption agency may be required by law. When choosing an adoption agency, first decide if you want your adoption to be domestic or international. If planning a domestic adoption, do you want to adopt an infant or a foster child?


When researching adoption agencies, prepare a list of questions. Here are some to consider:

  • Which states are you licensed in? What is the standing of the license?
  • How long have you been doing this type of adoption?
  • What do you require from prospective parents?
  • How many successful adoptions has your agency facilitated?
  • How do you prepare prospective parents?
  • What are the fees?
  • Is there a refund policy if an adoption doesn’t work out?
  • Do you offer any post-adoption services?

If planning an intercountry adoption, here are some additional questions you may want to ask:

  • In which countries do you operate? How long have you dealt with these countries?
  • Do you have overseas staff? Whom do you work with in other countries?
  • How do you identify children eligible for adoption in other countries?


Adoption Home Study

A doctor's exam ensures that the prospective parents are healthy and capable of handling the stress of raising a child.
Photo courtesy Dreamstime


A home study, also known as a family study or family profile, is an essential part of the adoption process. The study is a report written by a social­ worker who meets with the applicants several times and gets to know the family. If you’re using an adoption agency, the social worker will be one contracted by the agency. If you are pursuing another method of adoption, the home study should be done by an independent licensed social worker. The home study is used to present the family to adoption agencies and adoption exchanges. It judges the prospective parents’ ability to provide for a child and determines any special needs they can accommodate. The home study also educates the prospective parents about adoption and aids in the process of facilitating a good match.


The home study usually takes three to six months, but it can be shorter if the parents file paperwork and documents promptly and schedule their medical appointments early in the process. Foster care home studies usually cost $300 to $500, which can often be reimbursed following the adoption. Home studies for other types of adoption can cost $1,000 to $3,000. Make sure to discuss the fee with your adoption agency or social worker before the home study begins.

If you are undergoing a home study, remember that the agency isn’t looking for ”perfect” parents but rather parents who can provide a good, safe and loving home. As for the house,- what’s most important is that the home seems safe, livable and provides adequate amenities for a child.

When meeting with the prospective parents, the social worker educates the parents about the process of adoption and how to prepare for a new family member. The social worker interviews the prospective parents several times, conducting joint interviews with both parents, separate interviews with each parent or a combination of both interview formats. If the family has adult children living outside the home, they may also be interviewed. Children still living with the parents may, depending on their age, be interviewed or asked to write about their feelings regarding having a new sibling.

A social worker will want to see where the child will eat, sleep and play. With that in mind, he will personally examine the entire house or apartment, including the yard. Laws in some states mandate inspections by local fire and health personnel to ensure conditions in the home are suitable and up to code. The agency may require parents to undergo physicals to make sure they’re healthy and capable of handling a child. Serious health problems can complicate the approval process but are not automatically considered a negative characteristic. Similarly, a report from a mental health professional, if you’ve seen one and if such a report is required, doesn’t necessarily limit someone from adopting. In fact, if the report shows that a parent has overcome a particular disease or challenge, the adoption agency may regard that as beneficial for future parents.

In proving you’re capable of supporting a family, the adoption agency will require income statements and tax records. The agency may ask about outstanding debts, savings and insurance, especially with regards to health insurance for the child. Other documents that may be requested include birth certificates, copies of your marriage license and divorce decrees (if any). Finally, most states require background checks to confirm that you have no serious criminal record, especially one of child abuse

Many agencies require parents to write an autobiographical statement. The statement should represent who you are, with particular attention to your family life. Usually the social worker can help parents through the writing process or provide a set of questions that act as a guide. If you are participating in an open adoption, you might be asked to put together a scrapbook or photo album that can be shown to birth parents when they are choosing adoptive parents.

Your agency will request three or four references. These should be people who know you well, have been in your home and, if possible, have seen you interact with children.

According to the Child Welfare Information Gateway, the final home study report will contain the following information:

  • Family background
  • Education and employment status
  • Marital status of applicant(s) and information about current relationship
  • Daily life and routine
  • Parenting experience
  • Description of neighborhood
  • Religious practices and plans for child’s religious upbringing
  • Feelings about adoption
  • Summary and social worker’s recommendation [source: Child Welfare Information Gateway]

Some agencies let applicants see the home study report. The information is often shared with other agencies and sometimes shown to birth parents. Make sure to ask your agency about their confidentiality policy and how they use home study reports.

Let’s now look at one of the most common methods of adoption, using a licensed private agency.


Licensed Private Agency Adoption


In a private agency adoption, the birth parents relinq­uish their parental rights to the adoption agency. The adoption agency then works directly with families wishing to adopt a child. The adoptive family won’t meet the birth parents, unless the adoption is an open adoption where there is interaction between the birth and adoptive parents during and after the adoption. In any case, the agency’s social worker matches the adoptive parents and the child.


The agency is required to abide by certain standards in terms of screening parents and monitoring adopted children. Preference is often given to families who appear more stable or compatible with the child, but again, there is no perfect family that agencies demand. Instead, agencies look for the best match.

When looking for a licensed private adoption agency, it’s essential to make sure that the agency is reputable. The State Licensing Specialist where the agency is located can tell you if the agency is in good standing and if it’s been the subject of complaints. Check with the state’s Attorney General’s Office to see if any legal action has been pursued against the agency. Look up the agency on the Better Business Bureau’s Web site to see if any complaints have been filed.

You should get at least three references from clients whose adoptions were at least three years ago. Ask these clients if they had any problems with the agency and if the agency was helpful and supportive, including after the adoption. You can also join an adoption support group and talk with other parents about their experiences with adoption agencies.

In the end, you should choose an adoption agency that can help you find the best match for your family. Friends, relatives and adoption support groups can be great references for finding an adoption agency. In the next section, we’ll look at the different types of adoption and how they work.


Domestic Adoption

­Of the approximately 120,000 children adopted in the United States each year, around 100,000 are adopted domestically. In 2002, 51,000 children were a­dopted from foster care.

When choosing to adopt an infant or a child, consider your resources, support system and whether you can adapt to the needs of caring for an infant. Waiting times for adoptions vary, but your agency may be able to offer you an estimate. Generally, there are fewer opportunities to adopt infants, for whom the waiting time can be up to two years.


Most domestic adoptions go through a licensed private agency, described in the last section. An identified adoption involves the birth parents and adoptive parents locating one another, but an agency still conducts the home study (more on this later in the article) and counsels the birth parents. A facilitated or unlicensed agency adoption involves a facilitator who, for a fee, links the birth parents and adoptive parents. In many states, these types of adoptions don’t fall under government oversight or regulation and the facilitator may not be trustworthy. In some states it’s illegal for a paid facilitator to help with an adoption.

Finally, there is the independent adoption, in which lawyers assist families and birth parents usually give consent directly to the adoptive family. If you pursue an independent adoption, find a qualified attorney, such as one who belongs to the American Academy of Adoption Attorneys, a group of practicing adoption attorneys who also work on adoption law reform and education. Not all states allow independent adoption, and its costs are less predictable than working with an agency. State law also dictates which expenses can be reimbursed by the adoptive family, such as paying for the birth mother’s medical care.

Costs for a domestic adoption vary and depend on whether an agency is involved and its fees. Expenses can range from $5,000 to $40,000, but $10,000 to $15,000 is more common. Federal and state subsidies are available for some adoptions.


Orphanages and Foster Care

Orphanages in the United States have mostly been replaced by residential treatment centers, but they are still prevalent in other parts of the world, especially in countries afflicted by poverty, famine, war or disease.
Photo courtesy stock.xchng

Many orphanages were set up in the United States by religious organizations during the 18th and 19th centuries. However, over time, concerns rose about poor­ conditions and discriminatory policies, particularly during the Civil Rights movement. Orphanages became associated with a low standard of care -- barracks-like accommodations, a lack of mental health and support services, poor food and insufficient funding.

Following World War II, most orphanages in the U.S. began closing. Take the Windy City as an example. In the early 1970s, almost every orphanage in Chicago was shut down by the Illinois Department of Children and Family. Half of the city’s orphanages had already closed between 1945 and 1960 [ref]. Over the past few decades, orphanages in the U.S. have been largely replaced with smaller institutions that try to provide a group home or boarding school environment. Most children who would have been in orphanages are in these residential treatment centers (RTC) or foster care.


Residential treatment centers, the modern descendent of orphanages, provide housing, mental health services, education and recreation. In testimony before the House Ways & Means Subcommittee on Human Resources for the Hearing on Promoting Adoption and Other Permanent Placements, Nan Dale, CEO of Children’s Village in New York, described her facility as “more like a boarding school than an orphanage -- more like a children’s psychiatric hospital than an orphanage.” ”It is a highly structured, heavily supervised boarding school with intense treatment services for children and their families” Dale said [ref].

Expressing deep opposition to bringing back orphanages, Dale spoke of the complex issues facing children such as those who come to Children’s Village, many of whom are victims of severe neglect or abuse and have behavioral and psychological problems. Bringing back orphanages would not solve many of the problems, Dale said, and instead there must be a ”full array of services” for children and families: preventive services to keep families together, foster families, adoption services, different types of group care facilities, after care and independent living services. Strong evidence indicates that residential group care works well for troubled children, and bringing back orphanages would, in Dale’s words, mean ”dropping down a rung on the evolutionary ladder” [ref].

Foster Care Adoption

As of 2005, 523,062 children were in foster care in the United States [ref]. Public agencies handle most foster care adoptions, also called special needs adoptions. Foster care children usually are in grade school or are teenagers and frequently have been the victims of abuse or neglect. Check with your local Department of Social Services to learn about foster children in your area who need adoption. If a potential match is made, the prospective parents will visit with the foster child, and if the visits are determined to be successful, the child will be placed with his or her new family. For more information on foster care, check out our article How Foster Care Works.


Intercountry Adoption

I­n 1990, American families adopted about 7,000 children from abroad [ref]. In 2006, they adopted 20,679 [ref]. These children are generally younger than children adopted domestically: in 2003, 46 percent were less than 12 months old, and 42 percent were one to four years old [ref].

There are particular challenges involved in adopting a child from another country, but the process can be equally, if not more, rewarding than adopting domestically. Because of U.S. law, children adopted from abroad must be classified as orphans, meaning the child must have been abandoned or his or her parents deceased. Intercountry adoption is also appealing because:


  • The waiting time is usually easier to predict.
  • You can choose which country your child comes from, learn about his or her culture and integrate that culture in your own life.
  • Contact with birth parents is rare.

The waiting time for an intercountry adoption is generally one to three years, and the adoptive parents often have to go to the child’s home country to pick up the child. Some sending countries -- the adopted child’s home country -- require prospective parents to visit the country of origin more than once. The cost for an intercountry adoption is usually $7,000 to $30,000, depending in part on how many trips abroad the prospective parents have to make.

Intercountry adoptions are done through an agency specializing in those types of adoptions. Parents who are matched with a child can often review information on the child; pediatricians sometimes assist in this process by helping parents look over the child’s medical records.

When doing an intercountry adoption, the first step is selecting a country from which to adopt. Sending countries are usually developing countries in Asia, Central and Eastern Europe, Africa and Central and Southern America. Compare adoption programs in several different countries in order to find one that best fits with your family’s needs and can help you find a child that you want. Depending on the country, children of certain ages may not be available.

The United States Citizenship and Immigration Service (USCIS) requires prospective adoptive parents (or one spouse from a married couple) to be U.S. citizens and at least 25 years old. The USCIS also requires a two-part application to be filed. The first part determines if you can provide a safe, loving home for a child. The second part of the application, filed after a match is made, determines if the child is an orphan as defined by the U.S. Immigration and Nationality Act.

After your paperwork is filed with the government and the agency you are working with, you will be matched with a specific child within a few months to a year. You will then receive a packet of information on the child, usually including medical records, information about the child’s life and a picture. You will have time to review this information and decide if you can satisfy the child’s needs. If you have any questions or concerns about the child’s medical record, feel free to consult a pediatrician.

After you decide you want to adopt the child, you must file with the USCIS Form I-600, Petition to Classify Orphan as Immediate Relative. While waiting for final approval, the child will visit a doctor approved by the U.S. embassy. After the orphan investigation and the medical exam are complete, the U.S. Consular office issues the child an orphan visa. If for any reason you have difficulties during this process, consult the USCIS Web site and if need be, ask your social worker or an adoption attorney to contact the USCIS.

As previously stated, some sending countries require adoptive parents to personally pick up their children. There can be some disadvantages to traveling to meet your child, namely cost, having to navigate an unfamiliar or even dangerous country and a potential language barrier. But there are also many good reasons to travel to the sending country: you can experience the child’s home country, meet the child earlier, learn about the child’s background and where he or she has been living, become more involved in the adoption process and learn what your child may need to adapt to his or her new home.


Coming Home

Once you bring your child home, you'll want to make sure to get him a new birth certificate and any other necessary documents.
Photo used in Public Domain

Once you bring your child home, you may have to finalize the adoption in court, depending on the type of visa he or she received. You should also obtain important documents for your child such as a new birth certificate, a Certificate of Citizenship and a Social Security Number.

Some sending countries have post-adoption requirements, including providing medical reports, written updates and pictures. Your adoption agency and the U.S. embassy should have information on any reporting that is required.


Beginning a new life can be difficult for a child. Remember that your adopted child is an orphan, one who very possibly experienced trauma or abandonment in his or her home country. The memories of this past can be a source of emotional strain. Other challenges your child may face include:

  • Adjusting to family life
  • Learning a new language
  • Being told what to do by new parents
  • Unfamiliarity with basic rights such as privacy or owning things

Even though your child had a medical exam in his or her home country, you should take your child to a local pediatrician for a checkup.

As your child grows up, be aware of his or her cultural and ethnic heritage. Try to integrate aspects of your child’s background into his or her new life. Consider talking with other parents who have adopted from abroad and joining a support group. You can also continue to consult your adoption agency. From these sources, you can learn how to talk with your child about what it means to be adopted and also how to maintain a positive connection with his or her homeland.


Failed Adoptions and Post-adoption Services

Socializing with other adopted children can help your child to feel like he is part of a community.
Photo courtesy stock.xchng

When p­lanning to adopt, it’s important to consider that what may seem like a disadvantage to you may actually be considered an asset by an adoption agency or birth parents. No family is perfect; each has its own idiosyncrasies, problems and unique dynamic. However, there are some things that could make an adoption difficult.

Criminal Record

The impact of a prospective parent’s criminal record depends on the circumstances involved. A misdemeanor many years before is obviously less severe than a DUI conviction.


Military Family

Unfortunately, members of the military who move frequently can have trouble adopting due to the concern that such a life will not offer the stability a child needs.

Other Factors

General safety concerns or a disruptive home environment can stand in the way of an adoption. Also, an adoption agency will be reluctant to deal with a married couple who has a seemingly unhappy marriage or who may be seeking to adopt in order to save a troubled marriage. Some adoption agencies will not work with parents above a certain age.

In the case of intercountry adoptions, dealing with foreign governments and their particular requirements can be difficult. Belarus has not performed any intercountry adoptions since October 2004, and although the Belarusian government changed its procedures in 2005, intercountry adoptions with the U.S. have not yet resumed.

Post-adoption Services

Depending on the agency or country you’re dealing with, certain post-adoption services, such as providing updates about the child’s well being, may be required. But adoptive parents should not ignore post-adoption services if none are required. Even an adopted infant or a child with no history of trauma may eventually need special counseling. And for a child who had a traumatic or disrupted childhood, a supportive environment and special care are crucial. When adopting, make sure that you’re prepared to deal with feelings of separation, loss or memories of prior trauma. Consider joining a support group or engaging in recreational activities for families with adopted children. Numerous non-profit organizations provide programs and counseling for adopted children and families. Some therapists specialize in dealing with adopted children and their parents. Remember: these providers are not just in case of a crisis. Group activities can allow adopted children to meet other kids with whom they can identify, and parents can interact and share experiences, give advice and provide support.

For more information about adoption and links to listings of public and private adoption agencies, support groups and government agencies, check out the links on the next page.


Lots More Information

Related Articles

More Great Links

  • Cmiel, Kenneth. “Orphanages.” Encyclopedia of Chicago.
  • “Ranking of Foster Care Population by State.” Pew Family Research.
  • “Frequently Asked Questions: Adoption.” Child Welfare Information Gateway, Sept. 18, 2006
  • “Getting Started: Adoption Packet 1.” Child Welfare Information Gateway
  • “Intercountry Adoption: Where Do I Start.” Child Welfare Information Gateway, 2006.
  • “Intercountry Adoption.” U.S. Department of State: Bureau of Consular Affairs, Feb. 2006.
  • “International Adoption.” U.S. Department of State: Bureau of Consular Affairs
  • “Federal, State and Tribal Laws.” U.S. Department of Health and Human Services: Administration for Children & Families
  • “Overview.” Child Welfare Information Gateway Sept. 28, 2006.
  • “Where Do I Start?”
  • “CWLA Testimony and Comments: Child Protection.” Child Welfare League of America. July 20, 1999.
  • “History of Residential Education in the United States.” Coalition for Residential Education.