Considering Adoption in the Midst of Infertility

"Why don't you just adopt?" All too often, couples experiencing infertility hear this question from well-intentioned family members and friends. Although having support for this decision would mean a lot to the couple, they do not feel supported when the word "just" is used. The question, "Why don't you just adopt?" implies that the decision to adopt is easy and that the process of adoption is simple. In fact, however, the decision to adopt is extremely difficult for most couples to make and the process of adoption is often complicated.

How will we know that it is time to consider adoption?

There is no right or wrong time to begin considering adoption. Some people like to look ahead; they may experience infertility as a long tunnel and feel the need to identify a light in the distance. Others will go through infertility treatment, believe it will work, and not consider any alternatives until they need to do so. Neither approach is right or wrong - just different.

Often, the two members of a couple approach adoption at different paces. One (many times the woman) may want to look ahead and may raise the possibility of adoption early in their infertility experience. The other (many times the man) will prefer to exhaust their medical options before considering adoption. Although these differences in approach can be distressing, I believe that it can offer balance; as one member pushes forward and moves the process along, the other holds back and modulates the speed of their journey.

Beyond temperamental style, other things can also prompt someone to consider adoption. Sometimes it is a reproductive event - a failed IVF cycle, a miscarriage, or, even more likely, bad news about one's chances for future success. Other motivations may be experiencing a feeling of envy when a friend adopts or when you see a Caucasian parents with their Asian child. And although you are unlikely to feel pulled toward adoption if your physician says, "Do you think it's time to think about adoption?" you may find yourself curious if one of the IVF nurses says, "Oh, we just saw the cutest baby - one of our long-time infertility patients adopted her."

What if my partner will not consider adoption?

Listen carefully and remember that there is a difference between "not yet" and "never." Many people who sound negative about adoption are really saying, "I'm not ready to think about it yet" or "I'm afraid of adoption." These normal responses to the prospect of adoption do not preclude adoption in the future. In fact, may of the people who are initially the most fearful and reluctant about adoption go on to be the happiest and most content adoptive parents. It seems that the struggles they endure to make the decision serve to strengthen their commitment once the decision is finally made.

Sadly, there are a few couples in which one person can never adopt. When this happens - when adoption is simply a closed door for someone - it can sometimes lead to a marital crisis. It is important for couples in this situation to seek counseling. The counseling may reveal that the person who is saying "no" is really saying "not yet." Unfortunately, it can sometimes reveal that the partners are stuck and need to re-evaluate their next steps.
What can we do to learn about adoption?

There are many ways to learn about adoption, some of which can be of immense help and others of which can prove counterproductive. I'll begin with the 'don'ts':

· Carefully evaluate what you see and hear about adoption in the media

Don't accept what you hear in the media (especially television) about adoption without further investigation. In general, the media seems to go out of its way to put a "negative spin" on adoption. If you seek information or support from the media, you may end up hurt and disappointed.

· Don't use the yellow pages or a list of agencies as your resource

Adoption is confusing, very confusing. In considering adoption, you need to get accurate information, ideally directly from an expert who can explain it to you and answer your questions. I encourage people to find an adoption consultant and to interview him or her. Keep in mind that a consultant is different from a facilitator; a facilitator is someone who arranges adoptions.

Since state laws govern the practice of adoption, this expert should be from your state. You want to find someone who can outline all your options and explain the differences among them; he or she can focus on your particular needs, interests and concerns. This can probably be accomplished during only one or two meetings. A consultant can save you time and money by eliminating the need to gather information on your own by attending informational meetings.

Things that you should consider doing include:

· Talk with people with experience

In addition to meeting with a consultant, you should also begin to speak with families in your state who have recently adopted. Although there is benefit in talking with people who have been through the adoption process years ago, more recent experiences are especially valuable in terms of adoptive parenting issues because adoption practice is always changing. By speaking to families with experience, you will be able to learn about specific agencies and facilitators from those who have used them.

· Gather adoption information from advocacy organizations in your state

You can get a list of these groups from your local RESOLVE chapter as well as from Adoptive Families of America at 1-800-372-3300. Their excellent publication, Adoptive Families , contains a calendar of events, which lists adoption meetings held throughout the U.S.

But, can we adopt?

Many people fear that if they make the decision to adopt, they will encounter more disappointment. Having gone down a long, painful road with infertility, they are reluctant to embark upon what may prove to be another distressing journey.

The good news is that, yes, most people can adopt. Most private adoptions (including nonprofit agencies and foreign adoptions) tend to be costly, making adopting an infant within a reasonable time frame of 1 to 2 years prohibitive for some people. However, public adoption of older children is an option. And since more and more employers are offering adoption benefits, you may find that your company will share a portion of the cost of your adoption.

Beyond cost issues, following are some other potential barriers to adoption:

· Age - Some agencies and foreign countries have age requirements for adoption. In addition, birth parents who select adoptive parents may have concerns about older parents. In general, it becomes more difficult to adopt when you are over age 40, but I have known couples in their late 40s who have successfully adopted newborns in this country or abroad.

· Criminal record - Most adoption agencies will work with someone who has been arrested for driving while intoxicated, providing there was follow up counseling and subsequent responsible use of alcohol. However, criminal records for other infractions could prevent an adoption. It is critical that you be honest regarding your history. In my experience, agencies are generally willing to do work with people as much as possible.

· Medical problems - Having a terminal illness would most likely prevent a person from adopting. However, most other medical problems can be worked with.

· Psychiatric problems - Having a serious psychiatric illness, such as schizophrenia or bi-polar disorder, could prevent someone from adopting. However, most other psychiatric conditions will have little or no impact on your ability to adopt. Once again, it is important to be honest about your psychiatric history, including substance abuse history. I have participated in several adoptions for parents with histories of depression, alcoholism and other 'ghosts in the closet."

How do we decide whether to adopt domestically or internationally?

In considering adoption, it is crucial that you follow your preferences and not be guided by misinformation or fears. Since there are no predictable and appreciative differences in cost or time frame involved between domestic and foreign adoption, take the time to carefully think about what you genuinely prefer and pursue that avenue to building a family.

Although the reasons for choosing domestic or international adoption are complex, following are some common reasons why one or the other is selected. Families who choose domestic adoption often do so because of:

· Age (both of the child and the adoptive parents) - Domestic adoption often means a newborn baby will be adopted directly from the hospital. It is also open to people of all ages, while some foreign governments set upper and lower age limits for parents.

· Medical history and care - With domestic adoption, families often have access to substantial medical histories from both birthparents and extended family members. Pre-natal and obstetrical care is likely to be better in the U.S. than in many foreign counties.

· Birth parents - With many domestic adoptions, families have the opportunity to meet their child's birth parents and to exchange non-identifying information. Some people seek more contact or work through an open adoption process.

· Cultural issues - Domestic adoption allows people to adopt a child who shares their national heritage. Although there may be ethnic and religious differences between the birth family and the adoptive family, both are Americans.

Families who choose international adoption often do so because of the following considerations:

· Celebration of cultural differences - There are many families who embrace cultural differences and who welcome the opportunity to become a multi-cultural family. Some have a tie to a particular culture while others simply wish to expand their horizons.

· Humanitarian reasons - Some prospective parents want to offer a home to a child who would not otherwise have one. The plight of children living in foreign orphanages is often compelling.

· Fear of birth parents - Although problems with birthparents are very rare (and not necessarily limited to domestic adoptions), the media have frightened some people away from domestic adoption. Some people choose international adoption because it is perceived as safer.

Can we pursue adoption while we are still in treatment?

You can explore adoption while you are still in treatment, but it is difficult to actively pursue it, because both infertility treatment and adoption are both extremely time consuming and stressful events. It would be very draining to try to do both simultaneously, and it could prove very confusing. What would you do if you were offered a baby having just learned that you were pregnant? What would you say if you were told that it was time to travel to China to adopt a baby and you were scheduled to begin an IVF cycle? Contrary to misinformation presented in the media, adoptions can happen very quickly.

In conclusion, my experience with couples going through infertility have helped me appreciate how painful it can be to end medical treatment and how challenging a task it can be to consider adoption. At the same time, however, I have also learned that most people are remarkably skilled at making good decisions for themselves. I have a profound respect for their need to move toward adoption at the pace that is right for them.

I am often reminded of a woman I once knew. She and her husband had gone through more than a dozen failed IVF cycles before they eventually decided to adopt. Within a few months of beginning their adoption efforts, they became the beaming parents of a baby girl. After they had come to visit me at the clinic where I worked at the time, several staff members were quick to say, "Why did they wait so long? Look how happy they are!" My response was that this couple could not have adopted before now. In fact, if they had done so, I doubt they would now be so happy. I explained that, like many people, this couple needed to go through great lengths to try and conceive a baby. They also needed to struggle with their many doubts and fears before moving. Once they were ready, they were able to truly embrace adoption.

Ellen Sarasohn Glazer, LICSW, is a clinical social worker specializing in infertility and adoption counseling in Newton, Massachusetts. The author or co-author of several books, she most recently coauthored. Choosing Assisted Reproduction: Social, emotional and ethical considerations (Perspective Press, 1998) with Susan Lewis Cooper; revised The Long Awaited Stork: A guide to parenting after infertility (Jossey-Bass Publishing); and edited Experiencing Infertility: Stories to inform and inspire (Jossey-Bass Publishing). Ellen can be reached by email at eglazer@gis.net.

Credits: Ellen Sarasohn Glazer, LICSW