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Adoption: Is Earlier Better?

A phenomenon is emerging where prospective adoptive parents are getting involved in the lives of the birth mother and their hoped-for child earlier and earlier.  Proponents note the positive benefits in terms of facilitating a more comfortable and connected open-adoption experience, where the birth mother can feel she has thoroughly vetted the parents-to-be of her child, and can have peace of mind regarding the care that will be provided.  Prospective adoptive parents are given the opportunity to provide support for the birth mother (and the in-utero child), likely increasing the potential for bonding more quickly and fully following the birth.  Not to mention, the engagement of adoptive parents with an ambivalent expecting mother early-on may dissuade the birth mother from seeking recourse to abortion.

Yet, others raise concerns about what can happen if the birth mother changes her mind; one author offers the following commentary [1] after such an event:

A more ethical adoption placement would occur where the Prospective Adoptive Parents’ (sic) were not in the hospital with the mother and family and there was no pre-birth contact between them. In this way the mother of the child would be free to make her decision without intervention and outside influences. Then, if she did decide to relinquish, she could after birth on her own time. The prospective adoptive couple could then be notified after the relinquishment consent was signed and after the revoke period had passed, when the child was completely free and available for adoption.

While this protects the birth mother’s self-determination in an excellent manner, it is not without consequences for the other parties involved, most importantly, the child.

Of course for many children, the dilemma of being wanted by too many adults is sadly not the case, especially internationally.  Those children who find themselves in orphanages around the world due to circumstances of war, poverty, or lack of willingness on the part of the birth parents to provide necessary care, are at great risk of languishing.  Research has clearly shown that the institutionalized care [2] provided in many such orphanages is damaging to the child’s development of normal, secure attachment patterns [3], which has deleterious psychological effects at least through adolescence.  These children often suffer from developmental delays [4] in their cognitive functioning, language acquisition and social behavior, for which secure attachments to caregivers are seemingly necessary.

Reasons For Hope

Research has demonstrated that (at least for some forms of attachment-related difficulties which are endemic to having been raised in orphanages) sensitive, nurturing foster care [5] (particularly if before 24 months) can aid in decreasing the signs of attachment disorder, predominantly for those who have the more inhibited type of attachment problems where children are prone to distance themselves from their caregivers.

The primary mechanism for this healing appears to be consistent human contact [6].  Being held, regular eye contact, having needs attended to in a nurturing manner, and particularly skin-to-skin contact are most likely candidates for what facilitates the positive changes.  Some have posited that actual brain modifications [4] occur in critical emotional-relational areas of the brain, improving stress responses damaged by the emotional neglect in the orphanages.  However, additional research is needed to better understand these complicated relationships.

Competing Goods, Competing Rights

In some cases, like those of international adoption situations where a child is languishing in an orphanage that is not staffed to provide optimal care, the only compassionate response is swift facilitation of a child’s placement in foster and/or eventual adoptive families, where he can receive the singular attention that will be most beneficial to his development as soon as possible.  However, when the circumstances involve a potentially-ambivalent birth mother whose child is not yet born, the equation becomes increasingly complex.

While necessarily respecting the right of a woman to thoughtfully consider whether she will raise her child or place the child for adoption, one must consider the research suggests that the facilitation of the bonding between infant and mother through skin-to-skin contact ideally begins at birth. [7]  This bonding assists breastfeeding [8], oxytocin release, organization of reflexes, and regulation of the heart rate (Moore, Anderson & Bergman 2009).  An ambivalent mother who begins this process will feel an extraordinary pull towards keeping the child, even if she had theretofore considered this not in the child’s best interest.  In many circumstances this is good, such as when the birth mother is actually fit to care for the child.  However, in the majority of cases, the reasons for giving up the child are tied to the mother’s inability to provide proper care, for reasons such as drug abuse, mental instability, abusive spouse or boyfriend, or simply a lack of interest in the child.

All adoptions involve some loss [9] for the child, in that even a newborn infant who is placed directly with adoptive parents is being separated from the only mother he has known.  Still, delaying the bonding experience for the child with his new mother is not an attractive option where the birth mother is not willing or able to provide it.

While there are no easy answers when dealing with such a powerful and poignant experience as childbirth and decisions about placing a child for adoption, one principle which might be applied is the preferential option for the most vulnerable, in this case, the baby.  While birth mothers and hopeful adoptive parents each carry their own pain and anguish, the person without choice in the matter should be at the forefront of everyone’s mind when deciding the timing and process of decisions; for the baby, it seems, earlier is better.