Estimating the annual domestic adoption rate and lifetime incidence of infant relinquishment in the United States. Contraception 2021;105:14-18. [PMID: 34418378 DOI: 10.1016/j.contraception.2021.08.008]

Health Care and Adoption Service Experiences of People Who Placed Children for Adoption During Adolescence: A Qualitative Study

STUDY OBJECTIVE

To understand the perspectives of people who placed children for adoption during adolescence DESIGN: We conducted qualitative interviews with adults who placed children for adoption during adolescence. We recruited participants through social media and two adoption-related organizations. We audio-recorded and transcribed interviews. Using thematic analysis, 2 investigators coded the transcripts and identified themes.

SETTING

Telephone interviews PARTICIPANTS: Adults ages 18-35 years old who placed children for adoption before they were 20 years old INTERVENTIONS: Semi-structured telephone interviews MAIN OUTCOME MEASURES: Qualitative data RESULTS: We conducted interviews with 18 individuals (median age of 32 years; range 21-35 years). The median age at pregnancy was 18 years (range 13-19 years). Seventeen participants identified as female and one as nonbinary. Themes included the following: (1) Negative experiences with counseling included limited empowerment to make choices about pregnancy or adoption options; (2) negative experiences with counseling included limited information about practical or financial support for pregnant adolescents; (3) negative experiences with the health care system included insensitivity or lack of awareness of the adoption plan at delivery; (4) positive experiences with counseling included comprehensive unbiased options counseling and adoption counseling emphasizing birth parent choice in openness and family placement; (5) positive experiences included longitudinal emotional support during pregnancy, particularly in ways that normalized adoption placement; and (6) participants desired therapy and/or psychological support following adoption placement.

CONCLUSIONS

Individuals who chose adoption after adolescent pregnancy described positive and negative encounters with health care and adoption professionals that could serve as targets to improve the overall care experience for this population.

"Adoption is just not for me": How abortion patients in Michigan and New Mexico factor adoption into their pregnancy outcome decisions

Objectives

In public discourses in the United States, adoption is often suggested as a less objectionable, equal substitute for abortion, despite this pregnancy outcome occurring much less frequently than the outcomes of abortion and parenting. This qualitative study explores whether and how abortion patients weighed adoption as part of their pregnancy decisions and, for those who did, identifies factors that contributed to their ultimate decision against adoption.

Study design

We interviewed 29 abortion patients from 6 facilities in Michigan and New Mexico in 2015. We conducted a thematic analysis using both deductive and inductive approaches to describe participants' perspectives, preferences, and experiences regarding the consideration of adoption for their pregnancy.

Results

Participants' reasons why adoption was not an appropriate option for their pregnancy were grounded in their ideas of the roles and responsibilities of parenting and fell into three themes. First, participants described continuing the pregnancy and giving birth as inseparable from the decision to parent. Second, choosing adoption would represent an irresponsible abnegation of parental duty. Third, adoption could put their child's safety and well-being at risk.

Conclusions

Adoption was not an equally acceptable substitute for abortion among abortion patients. For them, adoption was a decision that represented taking on, and then abdicating, the role of parent. This made adoption a particularly unsuitable choice for their pregnancy.

Implications

Rhetoric suggesting that adoption is an equal alternative to abortion does not reflect the experiences, preferences, or values of how abortion patients assess what options are appropriate for their pregnancy.

Who are the women who relinquish infants for adoption? Domestic adoption and contemporary birth motherhood in the United States

INTRODUCTION

The social context of pregnancy decision-making has changed in recent decades in the United States (US), but little research has examined how these changes manifest in the context of infant adoption.

METHODS

To create an updated profile of US birth mothers, this analysis uses demographic data collected and aggregated from six adoption agencies, with information on 8658 private adoptions that occurred between 2011 and 2020.

RESULTS

Based on this sample, birth mothers today are older and more racially and ethnically diverse than counterparts in previous generations; a majority have other had children and a substantial proportion were parenting other children at the time of relinquishment. They report living on low incomes and, when considered with other measures (e.g., employment, health insurance, homelessness), seem to lack the economic resources that would give them meaningful power over the options available to themselves and their children. Most birth mothers contact agencies late in their pregnancies or after delivery, at a point when abortion care is likely inaccessible or unavailable. An important minority of birth mothers will relinquish more than one infant for adoption over the course of their reproductive lives.

CONCLUSION

Given the underlying shift in the demographic profile of women who relinquish infants, it is likely that the underlying circumstances that lead to adoption have also diverged. More research is needed into how women make decisions about adoption; such research carries implications for how best to support women's decision-making and ensure access to needed services throughout pregnancy and beyond.