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Adoption Options

Thinking about adoption, but not sure which kind is right for you? Here’s an overview of options—how they work and what they cost.From the Adoptive Families 2012 Adoption Guide by Lois Gilman and Susan Freivalds

If you're just starting on the adoption journey, the wide array of choices before you can seem daunting at first--with each varying considerably from the next! With more options come more decisions, each with its own emotional and financial risks and benefits. To help you find the right path, here's an overview of common routes to adoption. 

Adopting a domestic infant via an adoption agency
Hopeful parents-to-be who seek a healthy, U.S.-born infant often enlist the help of an agency. Private agencies set their own criteria on applicants they will accept, some more restrictive than others. In the past, those using an agency had their names added to a list and waited for a match. Today, the trend toward openness means you're likely to meet the birthparents, who may request ongoing contact with the child. The agency is likely to send a few sets of parent profiles to the potential birthparents, who pick the one they are most comfortable with. Then, the birthparents and adopting parents meet. At least half of the 15,000 or so domestic agency placements of infants each year involve such meetings. The child may be placed with the adopting parents immediately after birth or from foster care. If you insist on a closed process, your wait may be longer, since most agencies now encourage varying degrees of openness.

Typical Cost: $20,000 to $40,000, including the homestudy, counseling for potential birthparents and prospective adoptive parents, medical expenses, and foster care, if needed.

If service and support are what you want, an agency guides you through each step of the process. Fees are typically predictable.

Risks: The agency's criteria and the birthparents' desires for adoptive parents, in addition to your own specifications for a child, can affect the time it takes for you to be matched with a birthparent. A "false start" can occur--about half of prospective birthparents later decide against adoption, although most who change their minds do so before birth.

Adopting an infant privately
The other common way of adopting a domestic infant is by locating a potential birthmother yourself, usually with a lawyer's help. Of the estimated 18,000 annual domestic newborn adoptions, at least half are done independent of an agency.

Independent adopters mail résumés to obstetricians and attorneys, advertise in newspaper classifieds sections, and even create personal Web pages or biographical blogs in order to match with a birthparent. Once a match is established, adoptive and birthparents together arrange a plan for the adoption, hospital stay, and ongoing contact, if desired. The baby typically is taken home directly from the hospital.

Elise and Robert Sandiford of Los Angeles sent notes to their friends expressing their wish to adopt a newborn. A former neighbor in Chicago gave the letter to her rabbi, who passed it on to a pregnancy counselor in Colorado, who showed it to a teen client. The Sandifords traveled to meet the teenager, brought her back to California to live with them, and paid her counseling fees and medical bills. Three and a half weeks later, they were in the delivery room for the birth of their daughter, Kira.

Each state has its own laws governing independent adoptions (which are illegal in Colorado, Connecticut, Delaware, and Massachusetts). In some states, for example, an attorney can head the search for a birthmother for you. Or you can search on your own and hire a lawyer to screen prospective birthmothers and handle the legal paperwork. A search can take six months to more than a year. In "identified adoption," a hybrid of agency and independent adoption, adopters find a birthmother on their own but use an agency for services such as the homestudy and birthparent counseling.

Typical Cost: $7,000 to $10,000 in legal fees for yourself and the birthparents, plus at least $7,500 in medical expenses. At the high end, these expenses can total more than $35,000.

Benefits: You control the search process and the degree of openness with the birthparents, have direct contact with them, and aren't restricted by agency requirements.

Risks: Costs are largely unpredictable. Advertising, counseling, and living expenses for the birthparents vary widely from adoption to adoption. Length of time to find a birthmother varies as well. As with an agency match, a birthparent can change her mind before finalization.

Adopting internationally
In 2011, Americans adopted 9,319 children from other countries, usually young children from orphanages in developing nations of Asia, Eastern Europe, Africa, and Latin America.

Most intercountry placements are handled by U.S.-based agencies, which often facilitate adoptions in multiple countries, each with its own policies on who may adopt and who may be adopted. The placing organization abroad may be a governmental body, private orphanage, foundation, or other social welfare group. Most countries require that one or both of the adoptive parents travel to the country to pick up the child.

Children available for adoption may struggle with undernourishment, developmental delays, or emotional problems, but be otherwise healthy. Adopters often consult a doctor with international adoption expertise to review a child's records before accepting the referral, and to examine the child once home. The American Academy of Pediatrics maintains a list of adoption medicine specialists organized by state, at Remember, adopting a child from another country may mean that the family will become a transracial or cross-cultural unit, which will present special responsibilities for the parents.

Typical Cost: $15,000 to $50,000, depending on travel and other requirements of the country.

Benefits: The length of wait and fees have been predictable in the past, although changes in adoption programs have lessened this certainty. Matches are fairly routine and are typically processed in the order in which dossiers are received, making international adoptions a good alternative to those who like not having to be chosen by birthparents.

Risks: Paperwork required by the U.S. government, as well as the sending country, can be cumbersome. Medical information can be erroneous or incomplete. Policy changes or domestic problems in the sending country can delay or suspend the process. Studies show that almost all children catch up developmentally, but there's always a risk of long-term problems for any child who has spent time in an orphanage or other institution.

Adopting from foster care
In 2010, an estimated 52,891 "waiting children" were adopted within the U.S. from the public foster-care system. State agencies handle these adoptions, which typically happen in one of two ways: Families apply directly to adopt a child in foster care, or first become foster parents and then adopt after the birthparents' rights are terminated.

Children waiting to be adopted from foster care average 8.1 years old, according to the AFCARS 2010 fiscal year report. Most are deemed to have special needs because of physical, mental, or behavioral disabilities, age, or membership in a minority or sibling group. Photos of waiting children can be viewed at

Typical Cost: $1,500 to $3,500 in initial expenses, but fees can be recouped through a federal reimbursement plan or the adoption tax credit. Many families will receive the federal tax credit ($12,650 in 2012), regardless of their actual expenses.

Benefits: Reimbursements make cost negligible, and ongoing subsidies (averaging $350 per month) are available to help pay for the child's needs, including medical and counseling, day care, and tutoring.

Risks: Older children may have emotional, physical, or mental disabilities, or other special needs. The process can take a while because state agencies often are understaffed.

Lois Gilman is the author of The Adoption Resource Book (Harper Perennial, 1998). Susan Freivalds, past executive director of Adoptive Families of America, is founder and editorial advisor of Adoptive Families magazine.

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