• In adoption, a birth parent places the child in the care of another person or family in a permanent, legal agreement.
  • The birth parent selects the type of adoption (open vs. closed) and may influence who will facilitate the process (agency, attorney, facilitator).
  • Social workers are a helpful resource for patients navigating adoption.
  • Prospective adoptive parents undergo an evaluative home study, which includes interviews, home visits, health evaluation, income, and references (NAIC 2022).
  • The birth parent may be given a limited period of time during which they may change their mind. After that, the courts reverse few adoptions.
Open Closed
In open adoption, there is a greater degree of openness and disclosure of information between the birth and adoptive parents and the adopted child. In closed or confidential adoption, the birth and adopting parents have no contact, but may share relevant medical history. Court records are sealed.


  • There is no updated central database on adoption and updated data are limited.
  • 70% of all U.S. domestic adoptions are open adoptions (Adoption Facts 2022).
  • Of U.S. infant adoptions, 59% occur through the child welfare system, 26% involve children born internationally, and 15% involve U.S.-born infants placed (Arons 2010).
  • The proportion of infants placed for U.S. adoption declined from nearly 10% before 1973 (the year Roe v. Wade was decided) to 1% by 2002 (Jones 2009).
  • Patients placing a child for adoption are more likely to be never married, young, higher income and more educated than those choosing parenting (Arons 2010).
  • Of U.S. reproductive aged women, it is estimated that < 1% has relinquished a child for adoption (Sisson 2022) and < 1% has adopted a child (Ugwu 2015).
  • Adoption rates translate to a lifetime relinquishment estimate of 0.9% of U.S. women.
  • Adoptive parents are more likely to be > 35, ever married, to have previously used infertility services, or to be men, than people who have not adopted (Jones 2009).
  • A 2017 SCOTUS ruling allowed same-sex spouses to be listed on birth certificates, and made adoption by same-sex couples legal in all 50 states (Adoption Facts 2022).
  • LGBTQ parents are estimated to be raising 4% of all adopted children in the U.S..
  • Patients who have ever used infertility services are 10 times more likely to have adopted than those who have never used infertility services (Jones 2009).
  • The rates of intercountry adoptions have decreased in the last 2 decades, and countries participating continue to change.
  • The Hague Convention on Protection of Children was introduced in 1993 as an international treaty providing safeguards to protect the best interests of children, birth parents, and adoptive parents involved in intercountry adoptions.


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