November is National Adoption Month. As we enter the month of November, I find it very important to acknowledge the diverse and complex experiences of individuals who are in the adoption community. Whether they are people who were adopted, people who made an adoption plan for their child or adoptive parents who made the decision to build their family through adoption. Each adoption story has a diverse set of experiences, dynamics, and emotional connection to adoption. As professionals who work in the adoption community it is crucial to be aware of implicit bias that you bring in the conversation surrounding adoption. To put adoption experiences into a black-and-white/good-or-bad category minimizes the voices in the adoption community that we so desperately need to hear.
As an adoption professional I have worked with individuals in the adoption community. This summer at the Postpartum Support International Conference I had the tremendous opportunity to present a session on “Serving in the Adoption Community: A Clinician’s Guide to Psychotherapy with Expectant and Birth Parents.” In this presentation I was able to highlight the experiences of birth parents who decided to make an adoption plan for their child.
As we acknowledge National Adoption Month this November, I would like to generate discussion in our perinatal community around birth parents’ mental health. In order to equitably open this conversation, we must first start with language. As we know in our field, language can empower or disempower people. In adoption there is language that dates back to historical oppression, disempowerment and honestly old school unethical adoption practices. Providers must be language aware when working in the adoption community to provide equitable care and ensure that the patient is empowered in all decision making.
Empowering language in the adoption community is ever evolving, like our times. Previously in the adoption community, if a person was considering making an adoption plan for their baby they were immediately classified as a birth parent. That language immediately creates the falsity that during pregnancy that they have relinquished their parental rights. Using the words such as “expectant parent” during a pregnancy where a person is considering adoption for their child is a phenomenal way to acknowledge that the person is expecting to birth a child but does not put any language surrounding pressure or a decision that the person is placing the child for adoption.
This language also empowers the expectant parent with legal implications. An expectant parent who is carrying a child cannot sign parental relinquishment until the child is born. This reminds the expectant parent that they are like any other parent and that once the child is born, they are empowered to make whatever decision is best for themselves and their child. Once a parent signs papers of parental relinquishment they can be considered a birth parent (once they are ready to accept that language). Knowing your state laws surrounding adoption and parental relinquishment for parental rights is crucial in serving in the adoption community.
Terms like “give away the baby,” “adopt out,” “give up,” or “put up the baby for adoption” disempower the parent(s) in their adoption decision. The term “put up for adoption” came from the days of the “Orphan Train” where children were literally put on an auction block and sold to “parents” who many times used them as indentured servants in the home. (There is a great book called Orphan Train if you are interested in understanding The United States history of domestic adoption). Using the correct language of “placing the baby for adoption” allows you to acknowledge the empowered and loving decision that the parent(s) made for this child. The process of making an adoption plan for a child requires diligent informed consent and is not a “giving away” process. Many times, when I meet with expectant/birth parents they share that the language that professionals in the community have used with them has caused tremendous harm to their already grief-filled decision.
Using inclusive language in the birthing community is crucial and creates safety for clients. Each birthing person that we serve in our community should be met with the same inclusive language and screening that we offer to the perinatal population, regardless if they are currently parenting a child. Expectant/birth parents encounter the same challenges that all birthing people do, with what I would argue are more risk factors for a Perinatal Mood or Anxiety Disorder (PMAD) due to grief and loss. When I spoke with 20 birth parents, 75% shared that they were never screened for PMADs and received no follow up clinical care post adoption decision. I would encourage all providers to remember that birth parents are like any parent and deserve the same clinical screening that you would provide to a birthing person or their partner. Many birth parents share that they have fears with screening and answering honestly due to fears of the system, and specifically fearing the adoption agency reporting back to the adoptive parents. Ensuring emotional safety and having role differentiation is crucial in protecting this community from undue harm.
Many clinicians have reached out to me over the years, unsure of their ability to work in a birth parent clinical space. My advice is always the same: if you can be aware of your implicit bias, join the patient where they are at and welcome them into your space with inclusivity and curiosity you will be able to build a relationship that offers safety. All perinatal mental health providers through PSI are trained with a phenomenal foundation in understanding how to utilize models in supporting people with grief, distress tolerance, and understanding and advocating their own needs. This care for expectant parents/birth parents in the adoption community is no different.
If I leave you with anything, please let it be that joy and pain can co-exist. That birth parents can love their child with the greatest love and want more for their child than they feel they are able to provide them with. Adoption is a phenomenal family-building option that comes with tremendous grief, difficulties with identity integration and even more complex dynamics that we strive to lean into with our clients.
Emily Morehead, MA, LPC, PMH-C
The Couch Therapy, PLLC in Texas