8 Essential Tips For Adoptive Parents

After an exhausting trip overseas, topped off by a 15-hour train ride, Margaret Schwartz, a single professional in her mid-40s, arrived at an orphanage in Ukraine, where she had 30 minutes to make one of the most important decisions of her life.

Moments later, and essentially without any formal training, Schwartz was on her way back to the U.S. with two toddlers in tow. She had just become the sole parent of two boys who had never been anywhere other than the orphanage in which they were raised. "I wasn't prepared for the enormity of it," Schwartz admits.

Let's face it: No amount of advice can fully prepare you for the life-altering event of becoming an adoptive parent. But there are some essentials that, when tackled early on, can pave the road to a smoother adoption process. We talked to a variety of experts on adoption — many of them adoptive parents themselves — and arrived at eight "must-dos" for anyone considering adoption.

No. 1: Ask Yourself If You're Prepared to Embrace Adoption

People often consider adoption only after exhausting all their options for becoming biological parents. "Certainly there are infertility patients who see adoption as an indication of failure, as symbolic of loss or shame," says Linda Applegarth, Ed.D., director of psychological services at the Center for Reproductive Medicine and Infertility in New York City.

As long as these feelings prevail, proceeding with the adoption process may not be in the best interest of either the prospective adoptive parent or child.

"When it becomes more about becoming a parent than getting pregnant — when couples can make that bridge — they're in a place where it's much easier to embrace adoption," Applegarth tells WebMD.

No. 2: Consider Both Domestic and International Adoption

Most prospective parents have a mental image of the child they hope to adopt, from the age and sex right down to the color of the child's eyes. That image may dictate where they begin their search for an adopted child. But the experts remind us that when it comes to domestic adoption, the choice isn't entirely up to the adoptive parents.

"It is still easier for a traditional couple to adopt. Birth mothers do want the stability of a two-person household that she can't provide," says Nicole Witt, executive director of The Adoption Consultancy, a Florida-based consulting group. While she says that in certain parts of the country there's more openness to nontraditional parents, the predominant preference of birth mothers is for a married couple to adopt their child.

Schwartz found this out when she began her adoption journey. "Unless you want to pay for private adoption or a baby falls out of the sky, it's very difficult to adopt an infant or child under the age of 6 domestically," says Schwartz, who wrote "The Pumpkin Patch: A Single Woman's International Adoption Journey."

She also found the international adoption process easier to navigate. "Even though there are a number of broad-based nonprofits that support domestic adoption, it's difficult for people to get the information they need," Schwartz tells WebMD. "There's such a cohesive network for international adoption. Once you pick your country, it's like you've become a member of a club. Immediately, you're presented with cut and dry information."

But often, international adoption is fraught with unknowns. Schwartz, for example, had to decide whether to adopt her two sons within minutes of meeting them. She had no way of knowing the full extent of any developmental delays or medical problems they may have had — only that they had been institutionalized from birth.

While international adoption clinics provide services in which medical experts will review videotapes and medical records of children adopted outside the U.S. before parents sign adoption papers, the information isn't always available in advance, and it is rarely complete.

"I try to identify medical and developmental issues that may come up so parents can be prepared. Sometimes, I get information from a sentence to 2 inches of medical records. Some is subjective, others objective. It's variable. I never say a child is low risk," says neonatologist Dana Johnson, M.D., Ph.D., director of University of Minnesota Children's Hospital's International Adoption Clinic.

No. 3: Decide if You Want an Open or Closed Adoption

Do you want a completely closed, confidential adoption in which you never meet or have contact with the birth parents, an open adoption in which the birth parent has access to your contact information, or something in between?

While the trend is leaning toward more open adoptions, says Witt, most adoptive parents fall somewhere in the middle.

:Most prospective adoptive parents are very wary initially, and want a fully closed adoption. But once they come out on the other end, almost every single parent is glad that they have information about the birth parent," Witt tells WebMD.

While advocates of open adoption sometimes argue that it reduces adoptive families' fear that birth parents will reclaim their child, there's ultimately no way to know how a birth parent will react once the child is born. Your best protection is to know that, in some states, birth mothers can't revoke an adoption after 30 days.

No. 4: Know The Costs Involved — And How to Defray Them

Depending on the type of adoption you pursue — private, independent, domestic, or international — adopting a child can cost anywhere from $4,000 to $30,000, according to the National Adoption Information Clearinghouse.

But there are ways to defray costs associated with adoption. In 2001, the adoption tax credit, which applies to all adoptions, increased to $10,390 for families earning $150,000 or less. Many employers provide financial benefits, like paid leave for newly adoptive parents and reimbursement for adoption expenses. The National Adoption Foundation offers low-interest loans to help ease the financial burden. So before plunging into the adoption process, find out roughly how much adoption expenses will cost you, and what types of financial breaks you can expect to receive.

No. 5: Use a Lawyer Who Specializes in Adoption

All adoptive parents must hire a lawyer to legalize the adoption. Experts suggest hiring someone with expertise in adoption.

"You wouldn't go to a podiatrist for heart surgery," says Becky MacDougall, director of domestic adoption and birth parent services at Sunny Ridge Family Center in Wheaton, Ill. "We usually recommend that people use a lawyer who specializes in adoptive law."

No. 6: Acknowledge The Potential Emotional And Physical Baggage

It's important for adoptive parents to recognize that a child's environment, both in the womb and during the first few years of life, can have a lasting impact on that child. For a high percentage of adopted children, that may mean exposure to drugs or alcohol in the womb and a lack of stimulation in an institution.

"I should have read more about what it was like to bring home an institutionalized child. Even my son, who was almost 3, had no verbal skills," Schwartz tells WebMD. "Nor was I prepared for the insulated life they had led. For instance, they had never seen a toilet."

"Initially, most [institutionalized children] need a very structured environment, with bland repetition, and not too many toys," says Johnson.

The possibility of substance abuse in utero also poses risks. "The baby may appear healthy, but there are long-term risks," MacDougall tells WebMD. In babies with fetal alcohol syndrome, certain areas of the brain don't develop properly. This can cause behavioral and learning problems later in life, she explains.

No. 7: Keep Expectations Realistic

"Parents have a lot of expectations of what children will be. Adoptive parents do the same thing. There's some built-in fantasy about any child," Johnson tells WebMD.

The truth is, says Johnson, the longer a child has been institutionalized, the more dramatic and lasting the effects in the child's development. "Most babies adopted before they are 6 months are going to do as well as any other baby. Of those adopted when they're older than 2 years of age, a significant percentage will probably have long-term issues related to institutionalization," Johnson tells WebMD.

If you're adopting internationally, seeking input about a child's medical and developmental status from an international adoption clinic can help check expectations. "Families who consult a medical professional at the time of the adoption consultation have more appropriate expectations," Johnson says. "We know that they're all going to get better. But it's nice to inform families of potential delays, and what they can do to help them."

No. 8: Prepare To Tell Your Child's Story

Years ago, the topic of adoption was taboo, even in households that embraced adopted children. Many adopted children grew up believing they were born to their adoptive parents. A seemingly unshakeable stigma surrounded adoption.

Fortunately, attitudes have changed dramatically in recent years, and the stigma surrounding adoption is lifting. "There's a much broader definition now of family," says Applegarth.

Adopted parents can help lift the veil further by being open with their children about adoption, from the beginning. "We really recommend that adoptive parents tell children that they're adopted, from the time they hold them in their arms. Tell them it's something to celebrate," MacDougall says.

SOURCES:: Margaret Schwartz, author, The Pumpkin Patch: A Single Woman's International Adoption Journey. Linda Applegarth, Ed.D., director of psychological services, Center for Reproductive Medicine and Infertility, New York City. Nicole Witt, executive director, The Adoption Consultancy. Dana Johnson, M.D., Ph.D., director, University of Minnesota Children's Hospital's International Adoption Clinic. Becky MacDougall, director of domestic adoption and birth parent services, Sunny Ridge Family Center, Wheaton, Ill. National Adoption Information Clearinghouse.

By Elizabeth Heubeck, M.A.
Reviewed by Louise Chang, M.D.
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