What Is Life Like for Birth Mothers After Placement?

On Your Feet Foundation's national survey provides insight into birth mothers' emotional experiences after placement and what can help them heal.

Insight into birth mothers' feelings after placement.

It’s twilight in Marin County, California, and 25 women of all ages and backgrounds are gathered around flickering candles arranged in the shape of a heart. The group leader reads a list of statements, and asks the women to step forward if the statement holds true for them.

“Step into the heart if you have ever been pregnant.” All the women step forward, some giggling nervously, others somber, then step back.

“Step into the heart if you have placed a child or children for adoption.” All the women again step forward, then back.

“Step into the heart if you had never met another birth mother before today…if you have felt ashamed or guilty about your decision…if you were able to help name your child…if you placed in the last year…if you have seen your child in the last year…if you hid the pregnancy from anyone…if you have struggled with depression that feels related to your loss.” Some women are now weeping openly, leaning onto each other for support. Others exchange smiles of recognition.

“Step into the heart if you love your child.” All the women step forward, as far as they can go, until they are a mass of love, tears, anger, grief, betrayal, laughter, and loss. And so begins the biannual retreat for birth mothers, sponsored by On Your Feet Foundation Northern California (OYFF), a coalition of birth parents, adoptive parents, and adoption professionals that provides services and support to women who have placed a child for adoption.

A Closer Look at Birth Parents

Birth parents remain the most under-served members of the adoption community, with little access to meaningful services, pre- or post-placement. Much research has been conducted on the health and development of adopted persons, but little attention has been devoted to birth parents. Pre-placement counseling for expectant mothers has become more common in the last decade, with many domestic agencies requiring sessions and attorneys recommending it as best practice, yet women may not be aware of or ready to explore their complex emotions at that time. And while there is more recognition that placing a child is one of the most significant, painful, and traumatic life events a woman can experience, that understanding has not yet led to comprehensive development of post-placement supports and services. It is not uncommon for women to feel that, once they leave the hospital, they are left to fend for themselves.

OYFF was founded in Chicago in 2001 to help meet that critical need for birth mother support. Today, chapters exist in Chicago, Northern California, and Colorado. In order to strengthen and refine our services, the Northern California chapter commissioned renowned scholars in the field of adoption, David Brodzinsky, Ph.D., and Susan Smith, MSSW, LCSW, to illuminate the emotional experiences of women who have placed a child for adoption. Here are key points from the national survey of 235 birth mothers (on average, 3.5 years post-placement), begun in 2011. We hope that, in sharing these findings with the broader adoption community, agencies, mental health professionals, and adoptive parents will provide more effective and compassionate services and support to expectant parents who are considering their options during the pregnancy and to birth parents during the placement process and crucial first years after placement.

Who are Birth Mothers?

The Birth Mother Profile: First, let’s take a closer look at who places a child for adoption. The study documents information previously considered anecdotal, including the fact that the profile of the women who place a child for adoption has changed. In the 1950s and 1960s, these women tended to be in their teens, unmarried, and may have been coerced into placing their children for adoption. Today, most birth mothers are in their twenties, have had some college education, and may be parenting other children at the time of the adoption. Contact with the adoptive family is now commonplace, with 83 percent of the women who participated in the survey reporting being involved in some type of open adoption. Nearly 70 percent of the women surveyed were Caucasian, yet all major ethnic groups were represented.

Why Women Choose to Place: Unplanned pregnancy is, by nature, frequently experienced as a crisis, something that the mother did not expect or want, and is not prepared for. Historically, adoption was the only option for unmarried women, as social and religious forces conspired to pressure a woman to place her child or face a life of ostracism and scorn. As some of the stigma has fallen away from single parenthood, and domestic adoption has become a more empowered choice, with some legal protections for the birth parents, women make the choice for myriad personal reasons. The common thread is an awareness of the limitations of her current situation—emotional, physical, familial, financial, or a combination of all of these factors. Universally, a birth mother’s core motives include love for her child and a genuine desire to provide her child with the best possible circumstances, even if that means conceding her right to parent in a traditional sense.

Hopes for Their Children: Birth mothers, like all mothers, want their children to have resources and opportunities, to have a stable home, to be cared for and loved. They also want their children to know that they are loved by their birth parents, that they were not rejected or abandoned. Finally, most birth parents hope to have ongoing contact with their children in some form, realizing that their presence fills a need in the child’s life, as has been demonstrated by adults from the era of closed adoptions.

“I placed my daughter for adoption because I wanted her to have the kinds of things I could not provide for her at that time. Her father and I were both 21. We could have parented her, but it would have been a struggle. We wanted her to live in a stable, two-parent home, with a family who had an abundance of time and resources. I was still in college, and significant people in my life discouraged the idea that I could be a good, competent parent. I grew up in a rigid, shame-based religion, and had internalized the church’s doctrine about unwed mothers. Although I was undeniably influenced by these external messages, I was ultimately guided in my decision by a deep, maternal love for my daughter, even though it broke my heart.” —SUSAN LEKSANDER

 The Post-Placement Experience

Compromised Emotional Health: 75 percent of the women surveyed reported that their emotional health was very poor, poor, or neutral in the first year after placement. 80 percent of the women directly attributed one or more of their problems to the loss of their child, and 90 percent reported one or more clinical symptoms or life stressors. The most common problems reported by one third or more of the respondents in the year following placement included depression (71 percent), guilt (64 percent), anxiety (48 percent), diminished self-esteem (55 percent), and sleep problems (51 percent). Taken together, these findings reinforce other research and self-reports that the loss of a child through adoption is a serious life stressor which poses a significant risk to a woman’s emotional and physical well-being.

“I was an absolute wreck after I placed. I found I was a completely different person than I was before, and I struggled to connect the two. I felt like no one on earth could understand what I was going through, and I myself couldn’t understand why I was so hurt over something that I had decided completely on my own.” —ANN OWEN

Ongoing Grief: The study by Brodzinsky, Smith, and OYFF demonstrates that a vast majority of women who place a child for adoption experience some level of grief surrounding the placement, and may continue to for years without necessary support. The grief is particularly salient in the first year following placement, and the outcome is dependent on the type and sources of support she receives. The loss and subsequent grief is further complicated because the loved one is psychologically present but physically absent.

The grief a birth mother experiences is complex in that it is not often openly acknowledged. Consider the experience of a divorce or other major life stressor—one often confides in one’s peers for empathy, comfort, and support. A woman who has placed a child for adoption may not know another human being who has experienced such a loss, and may not be comfortable talking about it with family or friends for fear of being judged. OYFF holds retreats so that birth mothers can connect with other women who share the same experience, as well as participate in restorative exercises and establish a support system that will be in place well beyond the weekend.

What Helps Women Heal

Unmet Needs: Respondents were asked about the kind of supports they needed but did not receive. The three greatest unmet needs were financial support (34 percent), emotional support from family (42 percent), and support from a mental health professional (34 percent). In addition to birth mother retreats, OYFF matches women (who find us through social media, area adoption agencies, professionals, and word of mouth) with volunteer mentors who work with them to plan and meet goals. It offers modest scholarships as well as grants for psychological counseling.

“I placed my son for adoption 15 years ago. For those 15 years, not only did I ache over the loss of my child, I ached for a certain understanding. Connecting with other birth moms at an On Your Feet Foundation retreat last summer was incredible. There is no better support system than one comprised of other women who have worn the same shoes.” —ANDREA SHAW

Expectations About Openness: A vast majority of the women surveyed (83 percent) reported being involved in some type of open adoption, and more than 70 percent reported currently being satisfied or very satisfied with the adoption. Openness was a significant factor related to a birth mother’s well-being, with women who were in regular, ongoing contact with the adoptive family reporting better emotional and physical health than women whose contact was limited or non-existent in the first year post-placement.

Perhaps more important than the extent of contact was the degree to which the birth mother’s expectations were met. Survey respondents who had identifying information about the adoptive family, but who had no contact after placement, and those whose contact was limited and later terminated, reported the greatest physical and emotional problems.

Implications and Next Steps

Expanding Services: To effectively grieve and heal from the loss, women need understanding, validation, and support from those around them, including family and friends. Birth mothers also benefit greatly from contact with other birth mothers to reduce stigma, normalize their experience, and provide an informal network of ongoing support. It is our hope that adoption professionals will incorporate these findings into their practices by providing expectant parents with more information about how the placement may affect them, immediately and in the long term, by offering more pre- and post-placement services, and by educating prospective adoptive parents about the importance of openness and honoring the expectations of future contact.

For prospective and adoptive parents, we hope the information presented in the study and in this article will help guide and shape your relationships with your child’s birth parents. Patience, honesty, and empathy are critical in forming and maintaining healthy and sustainable relationships. We hope that adoptive parents whose relationships with the birth parents are strained or broken will make an effort to repair them, with an adoption-competent mediator. For many birth mothers, the OYFF weekend retreats have come to symbolize everything we hope to offer them—recognition, emotional support, access to practical resources, and a chance to be part of a community. We hope that this type of support is available to all birth mothers on their journey toward acceptance and healing.

A NOTE ON THE LANGUAGE: The authors chose to use the term “birth mother” to describe a woman who has placed a child for adoption, but realize that this term does not represent the experiences or opinions of all women who relinquish their parental rights, and some may find it offensive. Other terms, such as first mother, natural mother, biological mother, birthmother, and, simply, mother, are also used to describe her. Most of the terms have fans and detractors in each corner of the adoption triad. The best way to determine a woman’s preference is to ask her.

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