Most adoptees wonder about their genetic origins and their health, but where do they go to learn about their birth family's medical history?

It was not until Emma May Vilardi began looking for the reasons behind the many illnesses that she had suffered that she learned that ancestors and genetics were the key to understanding her health problems. Daring a probate judge to unseal an adoption record, she quickly learned that her ancestors had succumbed to the same diseases.

Not all adoptees can find the answers they need, though. Most adoptees do not have their birth name or place of adoption and, therefore, are unable to make that inquiry. Even when they do, most medical history is not kept current, in part because many birth parents do not know where or how to update vital medical information. In private placements, where attorney's records are often the only records, medical information may be virtually nonexistent. Even when information was collected at placement, numerous illnesses or diseases may have surfaced after the adoptee's placement.

One solution to this problem was obvious to Emma May. With an endorsement from the American Academy of Pediatrics and the support of pioneers in the adoption reform movement, she launched the International Soundex Reunion Registry (ISRR). For the first time, all who had a need or a desire for contact with their kin had a place to make themselves available. It was strictly mutual, and it was free.

Announcements were sent to social service agencies encouraging them to affiliate with ISRR and to refer searchers to the registry. In 1975 the state of Montana was the first to affiliate with ISRR. Many groups across the country now routinely refer people to the registry.

Is any registry the solution to all adoption issues? Absolutely not! Reunion registries are only one tool. A greater understanding of the issues involved is necessary if society is to provide for the unique needs of the adoption community. Today, in response to demands from triad members, most states provide some post-adoption services. Many states impose restrictions on these services, though, including fees and waiting periods. This is unacceptable.

Other obstacles result from the insensitivity of those in authority. Birth mothers who do not remember the actual date of birth and sex of their child have been denied access to that data on the grounds that it is "identifying" information. State laws are often designed so that people born in one state and adopted in another cannot obtain post-adoption services in either state.

A registry service is not intrusive. Reunions that take place through a registry go well for most. Registrants choose their means of communication, although most want to meet as soon as possible. Closure can take place at the same time that a new chapter begins. Connections and answers are often most important to adoptees; they have questions about health, appearance, characteristics, traits, and the circumstances of their conception and placement. They love to find siblings. They seldom seek to replace their adoptive parents, though. These are observations based on many thousands of reunions that have occurred through ISRR.

Should registrants accept advice? Yes, indeed. Expectations of what each person will experience vary widely. The ISRR staff is quick to provide counseling when requested. Adoption support groups can certainly help as well, and publications are widely available to address the feelings that arise during reunions.

At this writing, the ISRR maintains registrations for more than 174,000 persons. The ratio of adoptees to birth family members has remained constant throughout the years: five adoptees register for every three birth family members. Obviously, the assumption that birth mothers do not want to be located has little validity. We have also found that the cause of the pregnancy is not a deterrent to registration; women who became pregnant following incest or rape are among our registrants. Some birth parents have admitted abandoning their children; although this is rare, ISRR once reunited a foundling with her birth mother and two full siblings.

What type of adoption reform would ISRR support? That's easy. First, total access to original birth certificates for adoptees. Second, an amendment to every state's vital statistics act to provide birth parents with a non-certified copy of their child's original birth certificate, for informational purposes. Possessing accurate information about the child's sex, date and place of birth, and the attending physician increases a birth parent's chances of being reunited.

For many of those who have been reunited through the ISRR, the registry was their only means of connecting with lost family members. For many others, ISRR is their only hope of one day being reunited. It was a remarkable woman of extraordinary vision and courage who undertook this important, humane task: this registry is Emma May Vilardi's legacy to the adoption community.