Post-Roe, is adoption a realistic alternative to abortion?

Five decades ago, Kathy Aderhold was told to keep a secret. 

The nursing student hid the reason for her monthslong absence from siblings and friends. She couldn’t bring a camera where she went, she says, let alone her full name. The other girls called her Kathy H. 

The secret weighed 6 pounds, 3 ounces when she opened her eyes to the world in the hospital wing of a Salvation Army maternity home in Omaha, Nebraska, in January 1972. For a few days after the birth of her daughter, Ms. Aderhold recalls being allowed to sit in a storeroom for one hour, away from the other mothers, and hold the soft-haired wonder she named Jessica Ann.  

“Every day I told her I would find her again,” says Ms. Aderhold, who knew what came next.

Facing pressure from her Catholic family as an unwed 20-year-old, and without counseling about alternatives, Ms. Aderhold says she felt she had no choice but to “surrender” her baby to a Catholic organization for adoption. 

Adoption was promoted as a way to save Ms. Aderhold, and other middle-class white women of her generation, from social shame. Instead, she says, secrecy and loss shattered her sense of self-worth.

Her story may seem far removed from adoption today, which Supreme Court Justice Samuel Alito offers as an alternative to abortion in his opinion for Dobbs v. Jackson Women’s Health Organization. That June ruling ended women’s nearly 50-year right to abortion through Roe v. Wade, decided a year after Ms. Aderhold left the maternity home, childless.

According to the justice, Americans who support abortion restrictions note that “a woman who puts her newborn up for adoption today has little reason to fear that the baby will not find a suitable home.”

Yet, while abortion opponents hail adoption as a mutual blessing for parents on both sides, the number of families wanting to adopt has long outpaced the number of women who choose to relinquish. And despite an increasingly open process in which birth mothers have a say in choosing a “suitable home” for their child, adoption remains a rare choice for pregnant women.

Several adoption practitioners interviewed doubt the Dobbs decision will change this. But some see the fresh attention to infant adoption, where concerns about informed consent still exist, as an opportunity to further improve the process. Key changes that could better meet expectant mothers’ needs include enhanced transparency and openness, along with better representation and resources. 

“Adoption is complicated, and it should not be seen as a simple solution to an unintended pregnancy,” says Janice Goldwater, founder and CEO of Adoptions Together, a nonprofit agency in Maryland. Beyond a one-time legal event, she adds, adoption has lifelong implications. “In a sense, we have to go against our biology,” she says. “We’re wired as living creatures to care for our young.” 

Secrecy and the sexual revolution

While stigma associated with unplanned pregnancies outside marriage still lingers in some communities, the social push for secrecy has largely dissolved. White women were the primary ones pressured to relinquish their babies during what’s called the American “Baby Scoop” era – between the end of World War II through the early 1970s.

Ms. Aderhold remembers routing letters home to Shelby, Nebraska, through someone in California, so that no one in her small hometown could detect that she was just 100 miles east in Omaha in a maternity home she likened to a “jail.” As she waited out her pregnancy, she says a priest warned her she’d go to hell if she kept the child. (The Salvation Army, in whose facility she lived and gave birth, did not respond to requests for comment. The agency listed on Ms. Aderhold’s relinquishment record, which later “reorganized” as Catholic Social Services of Southern Nebraska, hasn’t offered adoption services since the ’90s, says executive director Katie Patrick.) 

Over time, the sexual revolution reduced the emphasis on secrecy before and after birth, as stigma around pregnancy outside of marriage receded for well-off white women. For low-income women of color, a new stigma took hold, that of the “welfare queen.”

The end of the Baby Scoop era also coincided with a dramatic decline in relinquishment rates by never-married white women. A summary of research by Child Welfare Information Gateway offers “social acceptance of single parenthood” and a higher number of unmarried mothers in their 20s rather than their teens as possible reasons. Other researchers, including those at the Guttmacher Institute, attribute declines, in large part, to abortion.

Today, private domestic adoption in the United States – sometimes called infant adoption – is a complex institution subject to varying state laws. Families can match either through private, state-licensed agencies, or independently through self-matching or with the help of lawyers or unlicensed facilitators. It’s unclear how many infant adoptions are arranged outside traditional agencies, since the internet plays an outsize, untracked, and largely unsupervised role in expectant women and potential adoptive parents finding one another.

Faced with declining placements through adoption agencies, including prominent religious ones, many have scaled back their adoption services or stopped them entirely in recent years. Michigan-based Bethany Christian Services, a large evangelical organization, announced a reduction to its domestic infant adoption programs in the spring. According to a spokesperson this month, the decision to pause the intake of families at many of its locations remains in place despite the overturning of Roe.

Whether arranged through agencies or independently, some 25,700 private domestic adoptions took place in 2019, estimates the advocacy and membership organization National Council For Adoption in Alexandria, Virginia. That includes adoptions by relatives but excludes those by stepparents and is not limited to infants. NCFA research counts nearly 6,100 fewer in 2020, as the pandemic began, though changes to methodology make those figures hard to compare with prior years.

Unlike international adoption or adoption from state-run foster care, private domestic adoption rates haven’t been consistently tracked by the federal government, and the data NCFA collects from states varies widely.

“It’s hard to overstate how little we know, really, about private adoption in this country,” says Gretchen Sisson, a sociologist at the University of California, San Francisco, who studies abortion and adoption. 

Yet, however many adoptions occur annually and however mainstream the process has become, it remains the “first choice for very, very few women, whether or not they actually end up relinquishing,” says Dr. Sisson. Still, she estimates that the overturning of Roe could mean up to some 10,000 more private, infant adoptions a year. Comparatively, there were 930,160 abortions in 2020 counted by Guttmacher, a research organization that supports abortion rights.

“It grew truly into an incredible relationship”

Adoption professionals who resist one-to-one comparisons of adoption and abortion argue that relinquishing parental rights isn’t a reproductive decision but a parenting one. And though a birth mother’s desire for continued contact with her child may evolve over time, research suggests it can help her process grief.

Every family situation is unique, but “the data is pretty overwhelmingly clear that maintaining contact has benefits for everyone that’s involved,” says Ryan Hanlon, president and CEO at NCFA. 

Open adoptions, today considered the norm, can range from semi-open with limited contact through a third party, to fully open arrangements with visits. But no level of openness can be guaranteed. 

Jess Nelson in Michigan has seen both the precariousness and value of open adoptions. In 2011, when she became pregnant in her early 20s while finishing college, Ms. Nelson turned to adoption after it became too late for her to access an abortion.

“I chose adoption so that I wouldn’t have to struggle being a single mom,” she says. “I wanted more for her life than I could give her at the time.”

Ms. Nelson’s agency didn’t provide post-placement support, she says, and the adoptive family effectively closed what had been discussed as an open adoption involving text and Facebook messages. Within the same month that the adoption was finalized, the family sent her a Christmas card, she recalls, then never contacted her again. 

But Ms. Nelson has also witnessed the power of the alternative.

When she later became pregnant unexpectedly in 2017, she “self-matched” with an adoptive family through a friend of a friend, outside of an agency. She also found a counselor to help her work through her grief and trauma. Her second adoption remains open through regular communication and visits, she says. She has joined the adoptive family for a few holidays, including Christmas morning.

“It grew truly into an incredible relationship,” says Ms. Nelson, who works as a community manager at PairTree, an adoption startup based in Seattle, where she supports expectant mothers who create adoption plans.

The extent to which agreements outlining contact after placement are legally enforceable is hard to pin down. About half of states have some provision for enforceability, according to NCFA tracking as of July 2021, but the specifics vary widely.

Abrazo Adoption Associates, a Texas agency that specializes in open adoptions, has a voluntary, customizable post-placement contact agreement for defining how, when, and with whom outreach is permitted between adoptive and birth families. But the document, which parents on both sides sign, underscores that such contact is a “privilege,” not necessarily a right (as some Texas law firms also note), regarding private adoptions in the state.

“In an open adoption, there has to be a certain level of accountability,” says Elizabeth Jurenovich, founder and executive director of Abrazo. “There has to be a willingness on [both sides] to put the child’s best interests at the heart of everything that’s done,” she says.

The prospect of openness wasn’t a make-or-break factor for Keshia Allsup when she chose adoption. But the Texan in her early 20s says it did ease the placement process.

In the summer of 2021, Ms. Allsup juggled work in food service while raising two kids under the age of 3 on her own. Finding herself unexpectedly pregnant, she couldn’t imagine affording time off with a third baby – much less diaper money.

“I knew that I would not be able to give him the life he deserves,” she says.

Ms. Allsup is against abortion, with limited exceptions, so didn’t consider it for herself. Through an online search, she chose Abrazo Adoption Associates, because the nonprofit agency mostly serves infertile adults and she wanted to help someone who couldn’t birth a child on their own. Though leaving the hospital without the baby was hard, she considers her unplanned pregnancy a “blessing.” 

“Maybe not for me, but for somebody else it was a blessing,” she says.

Transparency before, during, and after adoption

Angie Swanson-Kyriaco found herself unexpectedly pregnant in 1997. She says she was underemployed and dealing with an abusive partner, and abortion was logistically not an option. 

She thumbed through the Yellow Pages and found a local adoption lawyer, who helped her connect with the adoptive parents she ultimately chose. But she says the attorney ended up representing both her and the adoptive family, though she didn’t pay any of those legal fees.

“I didn’t have an advocate for me and my child, because the focus goes to the prospective adoptive parents and their needs,” says Ms. Swanson-Kyriaco, executive director of MPower Alliance, a San Francisco-based support network for birth parents. Her organization offers grants for mental health counseling, education, and financial emergencies – examples of post-placement support that other professionals would like to see expanded. 

The frequency of dual representation in adoption today is unknown, but the Academy of Adoption & Assisted Reproduction Attorneys (AAAA) is clear in its Birth Parent’s Bill of Rights: “You have the right to be represented by your own attorney at no cost to you.”

But it’s impossible to ensure birth mothers receive independent counsel.

“That’s the problem. … We can’t help something we don’t know anything about,” says New Jersey attorney Deb Guston, adoption director at AAAA.

In light of ongoing concerns about the potential for coercion – including the legal and ethical minefield around what expenses hopeful adoptive parents can cover for an expectant woman – birth mother advocates say education and transparency are key.

Part of that transparency has come from birth mothers, or “first” mothers, themselves, who have gained visibility over decades of going public with their adoption stories. Advocacy and support groups like Concerned United Birthparents, which emerged in the ’70s, have encouraged that community.

“Maybe the hardest part of all was that for 35 years, I was in emotional isolation,” says CUB board member and activist Leslie Pate Mackinnon, a first mother herself, living in Asheville, North Carolina. “I didn’t know there was another woman out there who had been through what I’d been through.”

She’s among the critics who see adoption leaving expectant mothers open to intimidation, because of their often-desperate situations. So is Renee Gelin, whose regret over having placed her second child for adoption led her to co-found Saving Our Sisters. It works to help expectant mothers choose family preservation over adoption, she says, by connecting them with resources – like education about their rights and financial aid averaging $2,500 – through a national network of volunteers.

“There’s a lot of people who make a lot of money, you know, separating mothers and their babies instead of supporting them. … We are filling that gap,” says Ms. Gelin, the nonprofit’s president, based in the Tampa, Florida, area.  

Many expectant mothers decide to shoulder the challenges of parenting rather than give up their parental rights, because they’re attached to their child, notes Laura Sullivan, program director at the Choice Network agency in Ohio, which serves around 300 pregnant women a year and facilitates about 15 adoptions annually. Despite new abortion restrictions across the country, Ms. Sullivan says she is still referring interested clients to abortion funds and clinics as part of Choice Network’s options counseling.

“We believe that adoption can’t be a wholehearted and ethical choice that a woman makes unless all options are available to her,” she says.  

A friendship 

The only option Ms. Aderhold felt she had at the Nebraska maternity home five decades ago was to relinquish her child. But Ms. Aderhold, now based in Colorado, never let go of her daughter emotionally. Decades after giving birth, she searched for her for months, eventually cold-calling her in the late ’90s. 

Kathy H. had kept her promise to Jessica Ann.

Except her name is Corry Key.

The women met at the Denver International Airport the following winter. Asked to describe the encounter in separate interviews, both choose the same word. “Surreal.” 

Dr. Key grew up in what she calls a “wholesome” Catholic home, as an animal lover who eventually became a veterinarian. She says she was raised fully aware of being adopted and recognizes she may be “lucky” for generally not having felt compelled to find a genetic “missing piece.” Now with children of her own and living in Dardanelle, Arkansas, she says she was also concerned how her parents would feel if they learned she was searching.

“I’ve always had a very positive feeling about adoption because of being adopted, and that’s why I have my whole life been very pro-life,” says Dr. Key, who is Catholic. 

That’s tough for Ms. Aderhold, who supports abortion rights but says abortion was “not ever in the picture” for her in the early ’70s. Her experience not only soured her perception of adoption, but made her leave her Catholic faith. Yet despite their differing views, both agree their friendship is upheld by mutual respect and love.

Ms. Aderhold, who became a nurse and midwife and raised two children, has shared openly about her experience for years, served on adoption-related boards, and spoken with media. Now retired, she serves as a “search angel,” applying her skills in genetic genealogy to help others find long-lost relatives. 

In her Denver home, opposite the front door hangs a painting.

“It’s really special to me,” says Ms. Aderhold, pausing at the frame. 

In muted hues, a woman cradles an infant. Eyes are closed as they embrace. 

Dr. Key says she bought it as a gift, recognizing “she missed out on a lot of that with me.”