The lifelong impact of adoption.

• Author: Russell, Marlou

In many cases, birthparents have trouble dealing with giving up their offspring; adoptees want to know more about their biological roots and genetic history; and adoptive parents are being confronted with issues concerning the raising of their adopted children that no one had warned them about.

Imagine being an adoptive parent who has gone through years of infertility treatment. You recently have adopted an infant and are at a party with it. Someone exclaims, "What a cute baby. Why, I didn't even know you were pregnant!" You wonder if you need to explain.

Now, try to imagine being a birthmother who relinquished a child 25 years ago. You since have married and had two more offspring. You strike up a conversation with someone you've just met. She asks, "How many children do you have?" You hesitate for a moment, then answer, "Two."

Finally, imagine that you were adopted as an infant. You have an appointment to see a new physician for the first time. When you arrive at the office, you are given a two-page form asking for your medical history. When you meet the doctor, he asks, "Does cancer run in your family?" You respond, "I don't know."

The adoption triad has three elements: the adoptive parent or parents, the birthparents, and the adoptee. All members are necessary and all depend on each other, as in any triangle.

There have been many changes in adoption over the years. The basic premise of adoption in the past was that it was a viable solution to certain problem situations. The infertile parents wanted a child; a birthparent was pregnant and unable to raise her offspring; and the infant needed available parents. It was thought that all the triad members would get their needs met by adoption. The records were amended, sealed, and closed through legal proceedings, and the triad members were expected never to see each other again.

It was discovered, however, that there were problems with closed adoption. Some birthparents began having trouble "forgetting" that they had had a child and were finding it hard "getting on with their lives," as suggested by those around them. There were adoptees who wanted to know more about their biological roots and had questions about their genetic history. Some adoptive parents were having difficulties raising their adopted children and were being confronted with parenting issues that no one had told them about.

Clinicians and psychotherapists became involved because more and more adopted children were being...