Grieving

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 Information Gateway 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.

2. Gaining Control and Resolution

Acceptance of the loss and working through the grief does not mean that birth parents forget their birth child and never again feel sorrow or regret for the loss. Rather, it means that they are able to move forward with their lives and to integrate this loss into their ongoing lives. For those in an open adoption, this may mean developing a new relationship with the child and the adoptive parents. For birth parents whose child was adopted in a closed adoption, it may mean learning to live with uncertainty about whether the parent will ever see the child again.

A number of birth parents have written about their experiences (for example, see the books by Brenda Romanchik listed in the resource section at the end of this paper). These authors describe a number of different ways of dealing with loss and grief:

Entrustment ceremonies. Some birth parents describe a ritual or ceremony that took place when they entrusted their child to the adoptive parents. In many cases, these entrustment ceremonies took place in the hospital. These ceremonies allowed the birth parents to say good-bye to their child and to maintain a sense of control over the placement. Such ceremonies may help with the later grieving process.

Ongoing rituals and traditions. Birth parents may find it helpful to create a tradition that honors the child and the decision that was made. For instance, planting a tree or writing a letter to the child (whether it is sent or not) are ways of acknowledging the loss. On special days, such as the child’s birthday, birth parents may want to continue with that type of ceremony or tradition.

Taking time. Both birth parents and counselors advise that birth parents must allow themselves time to grieve and recover (Roles, 1989). There is no timetable that predicts when the grief will be resolved, and there may be occasions, even many years later, when the grief may resurface. Birth parents who allow themselves time to grieve and to accept the loss may be better able to move on.

Finding Support. Birth parents should seek out friends, support groups of other birth parents, or understanding counselors in order to have a safe place to communicate their feelings. Being able to openly share feelings can be helpful in moving through the stages of grief and achieving some resolution.

Education. There are a number of books and articles about adoption and the birth parent experience, as well as a growing number of websites that carry information on the topic. Many of these include first-person accounts from birth parents, which can provide some context for what some other birth parents experience. These can be helpful to birth parents who may feel that they are essentially alone in their loss.

Writing. Birth parents may find it useful to keep a journal or diary of their experiences and feelings. This may serve as an outlet for grief or other emotions, and it can also serve to provide some perspective over time. Keeping a journal also allows birth parents to remember details that might otherwise be forgotten over the years.

Counseling. Birth parents may find that they need more support than family and friends can offer, or they may be unable to move forward in the grieving process. In such cases, professional counseling may help the birth parent make progress in dealing with the grief or may reassure the parent that such feelings are normal. A counselor should be able to help a birth parent replace unrealistic fantasy with reality, to acknowledge what has happened, and to heal.

Birth parents should look for counselors who have significant experience with adoption and with bereavement. Referrals for counselors may come from friends, birth parent support groups, or from the adoption agency or attorney who helped with the adoption.

While the birth parent will never forget the child, it is important that the birth parent adapts to the new circumstances and comes to terms with any regret. When birth parents are able to integrate the loss into their lives and gain some feeling of control, they can then move on to deal with whatever else life presents to them.

3. Resources

Books

Clapton, G. (2003). Birth fathers and their adoption experiences. Philadelphia: Jessica Kingsley Publishers.

Interviews were conducted with 30 birth fathers to relay information about their reactions and emotions during the pregnancy and postadoption periods.

Foge, L., & Mosconi, G. (1999). The third choice: A woman’s guide to placing a child for adoption. Berkeley, CA: Creative Arts Book Company.

Written by two adoption counselors, this book takes birth mothers through the periods of pregnancy, adoption planning and placement, and grief and recovery.

Gritter, J. L. (1997). The spirit of open adoption. Washington, DC: Child Welfare League of America.

A pioneer in open adoption practice, the author gives a realistic look at the pain, joy, and beauty that open adoption holds for all members of the triad.

Jones, M. B. (1993). Birthmothers: Women who have relinquished babies for adoption tell their stories. Chicago: Chicago Review Press.

The stories of a number of birth mothers are told throughout this book, which addresses all of the issues birth mothers encounter, including the pregnancy, placement, dealing with grief, marriage, later children, searching, and reunion.

Mason, M. M. (1995). Designing rituals of adoption for the religious and secular community. Minneapolis, MN: Resources for Adoptive Parents.

This handbook describes religious and nonreligious ceremonies, such as entrustment ceremonies, that might be used in adoption.

Mason, M. M. (1995). Out of the shadows: Birthfathers’ stories. Edina, MN: O.J. Howard Publishing.

The stories of 17 birth fathers are told to highlight the situation of this often forgotten group.

Pavao, J. M. (1998). The family of adoption. Boston, MA: Beacon Press.

The author, an adopted person and an adoption therapist, describes the developmental stages and challenges for adopted people, and includes real-life examples to illustrate these stages.

Roles, P. (1989). Saying goodbye to a baby. Volume I: The birthparent’s guide to loss and grief in adoption. Washington, DC: Child Welfare League of America.

Written by a social worker and birth mother, this book covers all of the issues faced by birth parents, including the pregnancy, adoption decision, loss, later issues, and reunion.

Romanchik, B. (1999). Being a birthparent: Finding our place. Royal Oak, MI: R-Squared Press.

This handbook, written by a birth parent, discusses the role of the birth parent in an open adoption.

Romanchik, B. (1999). Birthparent grief. Royal Oak, MI: R-Squared Press.

This handbook, written by a birth parent, discusses the different phases of grief, counseling, and dealing with difficult times.

Romanchik, B. (1999). Your rights and responsibilities: A guide for expectant parents considering adoption. Royal Oak, MI: R-Squared Press.

This handbook, written by a birth parent, discusses the responsibilities and rights of birth parents at each phase of the adoption plan.

Rosenberg, E. B. (1992). The adoption life cycle: The children and their families through the years. New York, NY: The Free Press.

Written by a clinical professor in psychiatry, this book draws on case examples to show how the different members of the adoption triad influence each other and to describe developmental tasks for those in the adoption circle.

Schaefer, C. (1991). The other mother: A true story. New York, NY: Soho Press, Inc.

The author tells her story of being a birth mother and of later searching for and finding her son.

Research Articles

Askren, H. A., & Bloom, K. C. (1999). Postadoptive reactions of the relinquishing mother: A review. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 28(4), 395-400.

The authors identified 12 studies with a total of 625 birth mothers, and they report the studies show that mothers are at long-term risk for repercussions; grief reactions, long-term effects, efforts to resolve, and influences on the relinquishment experience are discussed.

Connelly, M. (2002). Given in love: For mothers who are choosing an adoption plan. Omaha, NE: Centering Corporation.

This booklet describes some of the emotions that many birth mothers experience when making an adoption plan and addresses such topics as naming the baby, keeping mementos, writing letters, and spiritual grief.

De Simone, M. (1996). Birth mother loss: Contributing factors to unresolved grief. Clinical Social Work Journal, 24(1), 65-76.

The authors surveyed 264 birth mothers an average of 25 years after placing their infants for adoption to solicit information on such topics as unresolved grief, extent of social support, moderating variables, and reunion experiences. Higher levels of grief were correlated with the mother’s perception that she was coerced into the placement and with feelings of guilt and shame.

Deykin, E. Y., Patti, P., & Ryan, J. (1988). Fathers of adopted children: A study of the impact of child surrender on birthfathers. American Journal of Orthopsychiatry, 58(2), 240-248.

Questionnaire data provided by 125 birth fathers indicated long-term unresolved issues related to the adoption.

Fravel, D. L., McRoy, R. G., & Grotevant, H. D. (2000). Birthmother perceptions of the psychologically present adopted child: Adoption openness and boundary ambiguity. Family Relations, 49, 425-433.

Interviews with 163 birth mothers in the Minnesota/Texas Adoption Research Project show that the child placed for adoption remains psychologically present.

Portuesi, D. (1996). Silent voices heard: Impact of the birthmother’s experience—then and now. Adoption Therapist, 7(1), 1-4.

The author, a birth mother and psychotherapist, describes some of the emotional reactions of the birth mother, as well as ways that therapists can aid in the healing process.

Silverstein, D. N., & Kaplan, S. (1988). Lifelong issues in adoption. In L. Coleman, K. Tolbor, H. Hornby, & C. Boggis (Eds.), Working with older adoptees (pp. 45-53). Portland, ME: University of Southern Maine. Retrieved April 23, 2004, from http://fairfamilies.org/newsfromfair/1999/99LifelongIssues.htm

The authors describe seven issues that all members of the adoption triad must address.

Winkler, R., & van Keppel, M. (1984). Relinquishing mothers in adoption: Their long-term adjustment. Melbourne, Australia: Institute of Family Studies.

The authors studied 213 birth mothers who had placed children up to 30 years earlier and found that many had continuing experiences of loss, which were often worse for women who lacked social support and opportunities to discuss their loss.

Support Groups

Child Welfare Information Gateway compiles the National Foster Care & Adoption Directory, which lists support groups on a State-by-State basis.

One well-known national organization that also has some local chapters is Concerned United Birthparents (CUB).

Websites

American Academy of Adoption Attorneys

AAAA is a national membership association of attorneys who practice, or have otherwise distinguished themselves, in the field of adoption law. AAAA works to promote the reform of adoption laws and to disseminate information on ethical adoption practices. Their Membership Directory, including members from the United States and Canada, lists attorneys who are well versed in the complexities of adoption law as well as interstate and international regulations regarding adoption.

American Adoption Congress

The American Adoption Congress (AAC) is an international network of individuals and organizations committed to adoption reform. Through education and advocacy, they promote honesty, openness, and respect for family connections in adoption, foster care, and assisted reproduction. Membership is open to adoptees, birth parents, adoptive parents, professionals, and all others who share a commitment to the AAC’s goals.

Concerned United Birthparents (CUB)

CUB’s mission is to provide support to birth parents who have relinquished a child to adoption, to provide resources to help prevent unnecessary family separations, to educate the public about the life-long effects on all who are touched by adoption, and to advocate for fair and ethical adoption laws, policies, and practices.

Evan B. Donaldson Adoption Institute

The Adoption Institute seeks to improve the quality of information about adoption, to enhance the understanding and perceptions about adoption, and to advance adoption policy and practice.

Insight: Open Adoption Resources and Support

This site provides resources for all parties interested in open adoption, including expectant parents, adopted persons, adoptive parents, and birth parents.

Minnesota Texas Adoption Research Project

This site provides research findings from this major study of variations in openness in adoption and the effect of openness on all members of the adoption triad.

Child Welfare Information Gateway

Information Gateway offers information on all aspects of adoption for professionals, policymakers, and the general public. Information Gateway develops and maintains a computerized database of books, journal articles, and other materials on adoption and related topics, conducts database searches, publishes materials on adoption, and gives referrals to related services and experts in the field. Information Gateway also maintains a database of experts knowledgeable in various areas of adoption practice.

Information on the issues facing adopted persons can be found in the Information Gateway factsheet Impact of Adoption on Adopted Persons. The Information Gateway factsheet Searching for Birth Relatives. Information on open adoption can be found in the Information Gateway factsheet Openness in Adoption.