Universal Adoption Services

IN THE HOSPITAL: PART 8

How long do I want to stay in the hospital?

The answer to this question isn’t one that a woman makes definitively until after delivery.

The customary hospital stay after a vaginal delivery is 48 hours.

In our experience, a slight majority of birthmothers choose to leave one day after delivery. Of those who do, some are eager to leave as soon as they can simply because they don’t like to be in the hospital. Many wish to get back to their pre–pregnancy lives as quickly as they can.

Of course, this question is not as simple as it seems. Woven into the decision of when to leave the hospital are all of the complex feelings a birthmother has about her baby and her adoption plan.

And a companion question is: “How and when do I want to say my first real good–bye to my baby”?

We’ll address this question in a future post.


Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 7

Who will take care of my child(ren) at home while I am in the hospital?

If the children’s father is not in the picture, then usually a relative or friend cares for the kids while the expectant mother is in the hospital. When finances are tight, we provide some compensation to the relative or friend to help out with the extra expenses they incur by taking the children in for several nights.

In cases where the expectant mother has no support system, we find qualified care–givers for her children. The expectant mother calls them regularly, and we check in with them, too.

How will I get to the hospital?

Usually the expectant father, a relative or a friend is available and prepared to take the expectant mother to the hospital. Additionally, the expectant mother has a back–up plan, which often includes us.

In cases where the expectant mother has no support system, we take the expectant mother to the hospital.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 6

Do I want the prospective adoptive parents to visit with me while I am in the hospital?

Prospective adoptive parents come to the hospital only with the birthmother’s permission. And it is our practice to have an adoption counselor present whenever the prospective adoptive parents are there.

Most of the prospective adoptive parents we work with are very respectful of a birthmother’s desire for privacy and alone time with the baby.

When they do visit at the birthmother’s invitation, it is generally for a half–hour to an hour on the day the birthmother intends to go home. They may meet with the birthmother in her room for awhile without the baby present, then meet the baby in the birthmother’s presence, so she has an opportunity to see how the prospective adoptive parents and baby interact. Frequently, the prospective adoptive parents will take pictures of the birthmother with the baby and of themselves with the baby. The birthmother often does the same.

On occasion, the birthmother will invite the prospective adoptive parents to visit the baby, but she chooses not to meet with the prospective adoptive parents herself.

In many cases, the birthmother prefers not to have the prospective adoptive parents come to the hospital at all while she is there.

We support whatever the birthparent decides.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
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WHY WORK WITH AN AGENCY?: PART 1

A number of expectant parents and prospective adoptive parents opt for attorney–only or facilitator adoptions.

They believe they will have more control over the process, it will cost less (for the prospective adoptive parents), and/or it will exclude that “unnecessary” middle–man– the adoption agency. Prospective adoptive parents also may believe they will “get a baby” faster.

The reality for expectant parents is that while there is an illusion of control in an attorney–only or facilitator adoption, they often have less control than if they had worked through a licensed adoption agency. Furthermore, the expectant parent is far more vulnerable to subtle coercions to relinquish when choosing an alternative to an adoption agency.

Based on our experience working with prospective adoptive parents who choose an attorney–only or facilitator adoption:

• Many place a very low value on expectant parent counseling. (“How much will it cost us?”)
• They often use an attorney who is a personal friend (who may do the legal work at a reduced rate or for free). There is nothing inherently wrong with this, but frequently, the attorney has great experience and expertise in one area of the law, and little or no experience in adoptions. Also, the prospective adoptive parents typically expect the attorney to serve both their interests and that of the expectant parents. Expectant parents don’t always know that when an attorney represents the prospective adoptive parents, (s)he does not represent the expectant parents. All ethical attorneys (which includes most) will explain this to the expectant parents, but the ramification of this may be lost on an expectant parent, especially when there is no other entity looking out for the expectant parent, such as an adoption agency.
• Often, any financial support needed by an expectant parent is paid directly (or through the attorney or facilitator) by the prospective adoptive parents during the pregnancy. If the adoption does not go through, the prospective adoptive parents don't get that money back. Thus, an expectant parent may feel there is an obligation to follow through on her adoption plan.
• In attorney–only or facilitator adoptions, the prospective adoptive parents often have unlimited, direct access to the expectant parent. While there are benefits to this, there are serious risks that compromise an expectant parent’s ability to make a fully informed and free decision about adoption. For instance, every prospective adoptive couple has pain woven into their quest for adoption: An expectant mother may find herself trying to meet the prospective adoptive parents’ need for a baby rather than attending to her own needs or that of her unborn child’s.
• The prospective adoptive parents may promise an expectant mother the world, but without an outside intermediary (such as an adoption agency) to step in with some “reality checking” questions for both parties, she could be in for a cold shower after the baby is born and the prospective adoptive parents have custody of the baby.
• A lot of direct attention from the prospective adoptive parents may have the unintended consequence of denying an expectant parent the time and space she needs to really reflect on her adoption plan during pregnancy and after delivery. Without an intermediary such as an adoption agency, there is no one present to help serve as gatekeeper between the two parties.
• It is not uncommon for adoptive parents to become remiss in sending pictures and letters about the child, or to uphold agreements about meetings after the adoption is final. (More on this in a future post, but in brief, this is usually due to heartfelt fear of losing the child, and not out of animosity or unfeelingness toward the birthparent.) An adoption agency will advocate on the birthparents' behalf with the adoptive parents to follow through on their prior agreements. An attorney or facilitator may not.

There are prospective adoptive parents who choose attorney–only or facilitator adoptions who are also strong advocates for counseling, are able to respect boundaries between themselves and the expectant parents, and who support the expectant parents in whatever course they decide. There are also adoption attorneys and adoption facilitators who are highly ethical and skilled in what they do, who strive to meet the needs of both expectant parents and prospective adoptive parents.

If the prospective adoptive parents, the attorney or facilitator provides expectant parent counseling, that is the first litmus test to help you determine if (s)he might be the right resource for you – even if you are absolutely, positively sure you do not want such counseling. If the prospective adoptive parents, the attorney or facilitator does not provide expectant parent counseling, we suggest that you do not hesitate – go somewhere else.


Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 5

How much contact do I want with the baby while we are in the hospital? (Part 2)

A note about nursing staff

Nurses have opinions about adoption like anyone else. We find that nurses, as a group, are not more enlightened about adoption issues than the general population. Nevertheless, it is our experience that most nurses provide good physical and emotional care to birthparents, the infants, and the birthparents' family and friends.

When there are missteps in emotional care, they are usually a result of well-intentioned, but misguided, beliefs about what is helpful to birthparents.

There are, however, exceptions:

Like the general population, many nurses have positive feelings about adoption from the perspective of the adoptive parents, and perhaps about birthmothers in the abstract. But like the general population, a nurse may have ambivalent or even negative feelings toward a birthmother she encounters face to face. This may result in the following behaviors:

• ”Trading stations.” A nurse may swap patients with another nurse so she doesn’t have to work with the birthmother. We respect this decision: The nurse knows her attitudes may affect the quality of care she provides the birthmother, and she wisely excuses herself from the situation.
• ”Good intentions” manipulation. A nurse may actively discourage a birthmother from frequent care-giving or contact with the baby for fear it will cause the birthmother too much pain and/or that the birthmother will decide to parent. Or a nurse might actively push more care-giving or contact with the baby than the birthmother desires in an attempt to dissuade her from an adoption plan.
• ”The saboteur." On occasion, a nurse will try to talk a birthmother into parenting her infant.

When we observe or learn of an unhelpful behavior, we intervene in our role as birthparent advocate. We may talk directly with the particular nurse, her supervisor, and/or the hospital social worker. Depending on the situation, we may do any or all of the following: Review the birthparent's hospital plan with hospital staff; educate staff about birthparent issues; lodge a complaint; and/or ask that a nurse be removed from the birthmother's case. Regardless of how we respond, the objective is to ensure proper care for the birthparents; we do what is necessary to achieve that.


Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

OPENNESS OF ADOPTION: PART 5

Here is a thought-provoking article on the importance of education about open adoptions:
Painful Lessons: What We Must Learn About Open Adoption, For Our Children's Sake, by Marcy Wineman Axness.

It also offers a good discussion on prospective adoptive parents' relationships with expectant parents during pregnancy.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 4

How much contact do I want with the baby while we are in the hospital? (Part 1)

Again, this is up to the birthmother.

In our experience, most birthmothers like frequent contact with the baby after delivery. This holds true for birthmothers who, when they were pregnant, had decided they wanted very limited contact. Most – not all – change their minds after the baby is born.

In general, we believe that frequent contact is healthy for the birthparents:

• After delivery is the time for birthparents to “say hello” to the baby. Some therapists believe it is necessary to say hello before one can properly say good–bye. We support that view.
• This is also the time to re–examine the adoption plan. We suggest that a birthmother’s ability to hold her baby in her arms, look into the baby’s eyes, and tell the baby that an adoption plan is the right decision for the baby and herself is a sign of a fully informed, free–will decision. Or, as the birthmother holds her baby and looks into the baby’s eyes, the birthmother may decide that adoption is not the right decision for her and the baby.
• If a birthmother decides to follow through on her adoption plan, this will likely be the only time she has alone with her child. Many birthmothers treasure this alone time.
• This is the time for a birthparent to say good–bye – to whisper all the things she wants to say directly in the baby’s ear – to lavish the baby with assurances of love, kisses, tears, and tight embraces.
• For those birthparents with supportive family and friends around them, this is also the time for their loved ones to say hello, to hold and kiss the baby (and the birthparents), take lots and lots of pictures, and say good–bye.

Not every birthmother wants frequent contact with her infant after delivery. Some deny themselves contact as a way to protect themselves from more pain than they think can handle. We believe that we must work with a birthmother in the context of where she is now – not where we think she should be. We talk with her about the benefits of frequent contact; we talk through her concerns; she makes the decision. And she knows she can change her mind once the baby is born.

Some birthmothers did not bond with their babies while pregnant, and they are not interested in doing so after they are born. The maternal instinct is a bio-chemical process, and it doesn’t kick into gear for everyone. A note: The lack of bonding with a child does not equal lack of caring about the child's well-being. Also, we recognize that there are some expectant and birthmothers who are very, very skilled at hiding their feelings from others (and themselves!). We never assume that an expectant or birthmother "doesn't care" about her child, regardless of her statements or her outward behavior.

There are also some birthmothers who – at this time in their lives – do not have the capacity to bond with their infants due to serious personal issues of long–standing. Again, we respect where a birthparent is now; we don’t force her to go some place we think she should go.

Thus: Frequent contact with the baby in the hospital is probably the right decision for most; it is not the right decision for all.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 3

Who do I want with me in the delivery room? (Part 2)

What about the adoption counselor?

Just as we examine the presence of prospective adoptive parents in the delivery room, we must take a look at having an adoption counselor present.

In our experience, the adoption counselor is generally not in the delivery room.

But sometimes an expectant mother will ask the adoption counselor to be present.

The adoption counselor may be the only person the expectant parent knows who supports her in her adoption plan. Sometimes this is because the expectant mother is estranged from her family in all aspects of her life, not just adoption, her “friends” are really only acquaintances, and for whatever reason, the expectant father is not an option for her.

In other cases, an expectant mother may have generally good relations with her family, but her family members do not approve of her adoption plan, and they are either unwilling to participate in the baby’s birth or the expectant mother does not wish them to participate if they are unsupportive of her adoption plan.

Finally, an expectant mother may invite her adoption counselor to be present in addition to the expectant father, a family member or a friend. This may occur when the expectant mother has formed a particularly close bond with the adoption counselor and wants her to share the birth experience.

As with the presence of prospective adoptive parents, the presence of the adoption counselor in the delivery room can have the unintended consequence of exerting pressure on a birthmother to follow through on her adoption plan.

In making the decision for ourselves as to whether it is appropriate to accept an expectant mother’s invitation, we weigh the needs underlying her invitation with the risks of accepting it. If the adoption counselor is the expectant mother’s only support, we certainly accept the invitation and are grateful for the privilege.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 2

Do I want to restrict visitors to my room?

The expectant mother is in command of who is allowed to visit and who is not. Generally, a hospital will assume any of the expectant parents’ friends and family can visit unless the expectant parent states otherwise.

If the expectant mother desires restrictions on her visitors, we let the hospital know this in advance.

Who do I want with me in the delivery room? (Part 1)

Again, this is up to the expectant mother, although there will be a limit to the number of people allowed access, which varies according to a doctor’s or hospital’s policies. In our experience, most expectant mothers choose to have a parent, a sibling and/or a friend present. When they are on good terms, a number of expectant mothers invite the expectant father.

What about the prospective adoptive parents?

We do not recommend that a prospective adoptive parent be present during delivery:

• An adoptive parent’s presence may have the unintended consequence of exerting pressure on the birthmother to go through with the adoption plan. This may make it harder for her to change her mind about adoption after the baby is born for fear of the effect it will have on the prospective adoptive parents.
• For prospective adoptive parents, being present for the baby’s birth creates a presumption in their minds that the expectant mother will go through with her adoption plan. A subsequent change of heart by the birthparents is utterly devastating. NOTE: Nevertheless, concern about disappointing the prospective adoptive parents is not a good reason to follow through on an adoption plan.
• Many birthparents treasure the time they and their loved ones had alone with the baby. A prospective adoptive parent’s presence at delivery compromises that “alone time.”

Sometimes an expectant mother wants a prospective adoptive parent to be present during delivery, and feels surprised, hurt or resentful if the prospective adoptive parent is reluctant to accept the invitation.

A prospective adoptive parent may be unwilling to risk emotional trauma by witnessing the baby’s birth and then have the birthparent change her mind about adoption, even when the expectant parent is adamant about her decision to follow through on her adoption plan.

It can be difficult for expectant mothers to truly understand the painful path most adoptive parents traveled on the road to adoption (just as it is difficult for adoptive parents to truly understand the birthparents’ pain). It is not more sorrow than a birthparent suffers; it is a different sorrow, and it deserves the same respect as the birthparent’s.

Sometimes a prospective adoptive parent wants to be present for the delivery so she can experience all aspects of the baby’s life from birth. And, frankly, some want the subtle pressure that being present exerts on a birthparent. But most prospective adoptive parents understand when we explain that the expectant parents prefer that only family or friends be present.

Having said all of the above, adoption is about making free and informed decisions. When an expectant mother or prospective adoptive parent considers the prospective adoptive parents' presence at delivery, we explore the benefits and the risks with them. It is ultimately up to the expectant parents and the prospective adoptive parents to make the decision they feel is right for them.

Here is another take on this issue by Michael Spry, an adoptive father in two open adoptions. Mr. Spry writes beautifully on the benefits of the adoptive parents' presence at delivery for the birthparents, adoptive parents and the child. He also addresses the risks.

And an article by therapist Marlou Russell, Ph.D.: Hello Before Goodbye.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

IN THE HOSPITAL: PART 1

Getting ready for delivery

We help the expectant mother work through questions such as these:

• Do I want to restrict visitors to my room?
• Who do I want with me in the delivery room?
• How much contact do I want with the baby after (s)he is born?
• Do I want the prospective adoptive parents to visit with me while I am in the hospital?
• Who will take care of my child(ren) at home while I am in the hospital?
• How will I get to the hospital?
• How long do I want to stay in the hospital?
• How do I want the adoption agency involved in my labor and delivery, if at all?

Weeks before the baby is due, we notify the hospital’s social services department that the expectant mother has an adoption plan and we share with the social worker the expectant mother’s desires for her hospital experience.

Depending on the hospital, the social worker may meet with the expectant mother weeks or days before she goes into the hospital, or soon after she is admitted. The social worker will review with the expectant mother her desires for the hospital stay. Most social workers will also talk with the expectant mother about her intent to place her child for adoption to ensure she is making a fully informed and free decision. And, as we will have done already, the social worker will go over the hospital’s legal and administrative procedures as they relate to the expectant mother’s adoption plan.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

MONEY: PART 1

Expectant parent expenses

This is what Missouri law has to say about financial assistance for expectant and birthparents by prospective adoptive parents. Other states' laws differ to some extent.

This excerpt, similar to many other states' laws, is a gray area for both expectant and adoptive parents:

Reasonable living expenses, including but not limited to food, shelter, utilities, transportation or clothing expenses of the birth parents and child which are within the norms of the community in which the birth mother resides.

Typically, we help an expectant parent fill in the gaps of her living expenses in order to ensure a safe and healthy pregnancy and environment for herself and other children she may have at home. Sometimes this means we help her get her phone service turned back on, pay the occasional utility bill or help with groceries. Some expectant parents are virtually homeless, and they need far more material support. Others fall in between the two.

Why don't we routinely pay for all of an expectant parent's living expenses, regardless of her need? There are several reasons:

• Most expectant parents neither want nor expect such blanket support.
• Adoption is about making a fully informed and free-will decision. The more financial assistance an expectant parent receives, the more she may feel pressured to place her infant for adoption.
• Both the adoptive agency and most adoptive families have limited resources.
• Both the agency and adoptive parents must be able to justify to a court the financial support provided to an expectant parent. An agency could jeopardize its license for improper financial support; an adoptive family could lose custody of the child.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

OPENNESS OF ADOPTION: PART 4

As we noted in Openness of Adoption: Part 1, it used to be that most adoptions were closed. The birthparents didn't know anything about the adoptive family or the well-being of their child; the adoptive family and child didn't know anything about the birthparents.

Based on what you find on the web, it would appear that the pendulum has swung the other way to a bias toward open adoptions (rather than semi-open), in which the birthparents and adoptive parents have identifying information about and direct contact with each other.

We suggest that before you choose between open and semi-open, you do a lot of research. Both have strengths and challenges. You'll need to analyze which is best for you in your situation.

Because there is such a strong advocacy for open adoption on the web, with very little discussion about its challenges, we'd like you to know what some of these challenges are:

• An open adoption plan creates a presumption that the birthparents will establish and maintain a relationship with the child from infancy through adulthood. Most expectant parents (and their parents) tend to visualize their child only in his/her infancy or early childhood when making an adoption plan.
• Issues that contributed to a birthparent's pregnancy and/or decision to place her child for adoption may continue for quite some time. These issues may make it difficult to maintain a stable relationship with the child, despite the birthparent's most loving intentions.
• When the child is very young, this is not so problematic, but as the child grows older and fully understands who the birthparents are, you can imagine the possible effects when a birthparent is no longer in the picture because of things going on in his or her life.
• Some birthparents may arrive at a point in their lives when they feel it is in their best interests to detach from the adoptive famiy and child, but they feel trapped in the relationship.
• Maintaining a relationship with the child means maintaining a relationship with the adoptive parents. Conflict is inevitable, as is the case with any relationship, no matter how loving it is.
• Some birthparents and some adoptive parents may have trouble establishing healthy boundaries with each other. Birthparents may become too dependent on the adoptive parents for emotional support, distracting the birthparents from achieving their fullest potential.
• Adoptive parents may find themselves striving to "fix" the birthparents' problems (as they see them).

As part of your research into openness, we suggest talking with birthmothers who opted for open adoption, asking for the pros and the cons of their arrangements. Be wary of anyone who says that only open or only semi-open is the "right" way to go. Seek out especially those birthparents with children who are now of school age to get their seasoned perspective.

As with adoption itself, open adoption is the right decision for some; it is not the right decision for everyone.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

THE EXPECTANT FATHER: PART 2

Here is information about paternity testing:

Reasons to take a paternity test; reasons not to have a paternity test

Specimen collection. In cases where paternity testing is appropriate, we use buccal swabs for DNA collection from the expectant mother and father. The "specimen collection" link explains buccal swabs.

For the baby, we usually use what is called a "cord draw." When the baby is born, the delivery nurse takes blood from the part of the umbilical cord that is separated from the baby and puts it into a couple of tubes. We don't have to disturb the baby at all.

We almost always get the buccal swab specimens from the expectant mother and father separately. And we can do it anywhere - in our office, at the parent's house, or as we've done before, in a parking lot. We've also gone to prison a couple of times to get a buccal swab specimen.

If one of the parents lives far away, then we arrange for him or her to go to the closest testing lab or blood center to give his or her specimen, then that office sends the specimen by overnight mail to the lab that will run the test. It is important that the person doing the buccal swab follows the correct procedures, including checking valid identification, taking a photograph of the person giving the specimen and safeguarding the specimen until it arrives at the lab that will run the test.

About test results. A note about this. While the standard testing time is 10 business days, it is possible to get results sooner (at a higher cost). It is our practice to obtain the results in three days in the interests of the birthparents, the child and the prospective adoptive family.

Disclosure: All of the above links go to different pages on the PTC Labs website. We do not do this as an endorsement of PTC Labs. We want you to be aware, however, that this is the company we use for our testing.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

THE EXPECTANT FATHER: PART 1

Although there are exceptions (which we will address in the future), both the expectant mother and father must agree to terminate their parental rights (and sign a consent to adoption) before an adoption can take place.

For a number of reasons, the majority of expectant fathers do not participate in the early phase of adoption exploration with the agency. Based on our experience, the reasons include:

• The expectant mother does not wish to have contact with the father.
• The expectant father chooses not to participate, at least in the beginning.
• The expectant mother does not know where the father is.
• The expectant mother has concerns about involving the expectant father in the process, at least in the beginning.
• The expectant mother is not sure who the father is. This might be because she had multiple partners around the time of conception, the father is someone she didn't know, or a combination of the two.

If an expectant father doesn't come in with the expectant mother, then we negotiate with the expectant mother on when, how and by whom he should be contacted. Sometimes the expectant mother prefers to make the first contact; in other cases, she prefers the agency to do so. It is not necessary for the expectant parents to meet with the agency together.

This is what Missouri law says about consent to adoption by the birthfather.

Go here to get information about what the law is in your state.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
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CONTACT WITH AN ADOPTION AGENCY: PART 4

The adoption agency and the expectant mother will also explore:

• What the expectant mother wants her delivery experience to be like
• What the expectant mother is looking for in an adoptive family
• Extent of openness the expectant mother desires before and after placement
• Family planning for the future
• Grieving process

Here is one birthmother's take on choosing an adoption agency.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]

CONTACT WITH AN ADOPTION AGENCY: PART 3

In subsequent meetings, we and the expectant mother talk about the following:

• Answer her questions (always)
• Explain the adoption process (frequently)
• The expectant father (or alleged father), his whereabouts, and his feelings about a possible adoption plan
• Legal paternity issues (more on this in a future post)
• What's going on in her life; her concerns and how we can help her with them
• Her hopes and dreams for herself
• Her hopes and dreams for the child she is carrying
• Her hopes and dreams for children she already has
• Her physical health and ongoing prenatal care
• How her pregnancy and possible adoption plan are affecting the people around her; how she's dealing with that

THE HISTORY FORM: PART 1

Fairly early on in our relationship with an expectant mother, we will give her a long form to complete, which asks her about her social, biological, medical and geneological (ancestry) background. This form has several uses:

1. We let possible adoptive parents know of any health issues that might affect their decision to adopt this expectant parent's infant.
2. If the expectant mother selects an adoptive family, we give the information to them for their records.
3. The information is available to the child if (s)he needs it when (s)he is an adult.
4. If we didn't know it already, we learn if the expectant parents have Native American ancestry. If this is the case, there are special federal regulations we follow.

Universal Adoption Services
573.634.3733
uas~at~earthlink.net
[]