1. Responses to Adoption Placement

Grieving the Loss of the Child. Placing a child for adoption can cause a sense of loss that is all-encompassing. This sense of loss begins with the pregnancy itself as the expectant parents come to accept the reality of the unplanned pregnancy and the loss of their own immediate life plans. Most struggle with the decision to place the child for adoption; those who decide to do so begin to plan for a great loss in their own lives with the hope that placing the child for adoption will result in a better life for their baby and for themselves.

The actual physical separation generally occurs soon after the birth. Many circumstances can have an impact on the birth parent's feelings at the time, including mixed feelings about the adoption placement, support from other family members and the other birth parent, and whether the planned adoption is open (i.e., allowing some later contact with the child). The actions of the agency personnel (if an agency is involved), as well as those of the adoption attorney, adoptive parents, hospital personnel, and physician can all affect the feelings of the birth mother and father as they proceed through the process of the adoption and the termination of their own parental rights.

The birth and the actual surrendering of the baby may prompt feelings of numbness, shock, and denial, as well as grief, in the birth parents. All of these feelings are normal reactions to loss. This particular type of loss is different from a loss through death, however, because there is rarely a public acknowledgment, and friends and family of the birth parents may attempt to ignore the loss by pretending that nothing has happened. In some cases, the secrecy surrounding the pregnancy and adoption may make it difficult for birth parents to seek out and find support as they grieve their loss. In addition, the lack of formal rituals or ceremonies to mark this type of loss may make it more difficult to acknowledge the loss and therefore to acknowledge the grief as a normal process.

When birth parents first deal with their loss, the grief may be expressed as denial. The denial serves as a buffer to shield them from the pain of the loss. This may be followed by sorrow or depression as the loss becomes more real. Anger and guilt may follow, with anger sometimes being directed at those who helped with the adoption placement. The final phases, those of acceptance and resolution, refer not to eliminating the grief permanently but to integrating the loss into ongoing life.

Grieving Other Losses. Placing a child for adoption may also cause other (secondary) losses, which may add to the grief that birth parents feel. No one fantasizes about having a baby and then giving it up, so expectant parents who are planning to place the child for adoption may grieve for the loss of their parenting roles. They may grieve for the person their child might have become as their son or daughter. These feelings of loss may re-emerge in later years, for instance, on the child's birthday, or when the child is old enough to start school or to reach other developmental milestones.

Additional losses may occur as a result of the pregnancy and placement. In some cases, the birth mother loses her relationship with the birth father under the stress of the pregnancy, birth, and subsequent placement decision. The birth parents may also lose relationships with their own parents, whose disappointment or disapproval may be accompanied by a lack of support. In extreme cases, the birth mother may need to leave her parents and her home. The birth mother may lose her place in the educational system or in the workplace as a result of the pregnancy. Birth parents may also lose friends who are not supportive of either the pregnancy or the decision to place the child for adoption.

Guilt and Shame. Birth parents may experience guilt and shame for having placed their child for adoption, since societal values reflect a lack of understanding of the circumstances that might prompt birth parents to make an adoption plan for their child. At first, there may be shame associated with the unplanned pregnancy itself and with admitting the situation to parents, friends, co-workers, and others. Shame about the pregnancy may lead to feelings of unworthiness or incompetence about becoming a parent. Once the child is born, the decision to place the child for adoption may prompt new feelings of guilt about "rejecting" the child, no matter how thoughtful the decision or what the circumstances of the adoption.

The shame and guilt felt by birth parents is often supported by the secrecy surrounding the adoption process. Thus, keeping the pregnancy a secret, maintaining secrecy throughout the adoption proceedings, and then treating the experience as unimportant may promote a feeling of shame in birth parents, since the pregnancy and adoption are not even discussed. Birth parents who can discuss their feelings with supportive friends, family members, or professional counselors may more easily come to terms with their decision over time and be able to integrate the experience into their lives.

Identity Issues. Placing a child for adoption may trigger identity issues in some birth parents. They may wonder, "Am I a parent?" Some birth parents may experience a sense of incompleteness, because they are parents without a child. Generally, their status as parents is not acknowledged among family and friends. If the birth parents go on to have other children whom they raise, this may also affect how the birth parents view their own identity, as well as that of all their children.

These questions about identity may also extend to the relationship with the child when the adoption is open. Birth parents who participate in open adoptions may initially wonder how they will fit into that new relationship with their child once the adoptive parents become the legal parents. However, this relationship with the child and adoptive family in an open adoption may evolve so that the birth parents maintain an agreed-upon role in the life of the child. Still, there are few role models for birth parents to help clarify this issue of identity. (For more information about open adoptions, see the NAIC factsheet Openness in Adoption.)

Long-Term Issues. Many birth parents continue to mourn the loss of their child throughout their lifetime, but with varying intensity. For instance, birth parents may continue to track the milestones of their child's life by imagining birthday parties, first days of school, graduation, and more. Some birth parents experience longstanding grief, that is, grief that lasts a very long time and may continue to actually interfere with a birth parent's life many years later. Some of the factors that have been found to be associated with longstanding grief include:

• A birth parent's feeling that she was pressured into placing her child for adoption against her will
• Feelings of guilt and shame regarding the placement
• Lack of opportunity to express feelings about the placement

The personal stories of some birth parents, as well as studies with birth parents in therapy, have indicated that some birth parents experience difficulties beyond longstanding grief (see, for example, Winkler & van Keppel, 1984). For instance, some birth parents may have trouble forming and maintaining relationships. This may be due to lingering feelings of loss and guilt, or it may be due to a fear of repeating the loss. Other birth parents may attempt to fill the loss quickly by establishing a new relationship, marrying, or giving birth again—without having dealt with the grief of the adoption placement. A few birth parents report being overprotective of their subsequent children, because they are afraid of repeating the experience of separation and loss (Askren & Bloom, 1999).

For some birth parents, the ability to establish a successful marriage or long-term relationship may depend on the openness with which they can discuss their past experiences of birth and adoption placement. Some birth parents never tell their spouses or subsequent children of their earlier child. Others are comfortable enough with their decision to be able to share their past.