Counselors, Lawyers, and Doctors

Or, Is Comprehensive Counseling All That Important?

I don't want to sound crass about it, but when you are buying a house or renting an office, real estate people always say that there are three crucial criteria and only three: location, location, and location. Well, with adopting a child, there are only three criteria as well: counseling, counseling, and counseling. If the person you are dealing with does not mention counseling in the first sentence, and the second sentence, and the third sentence, and every other sentence from then on, head for the hills.

A successful open adoption takes considerable work and care. Open adoption requires determination and the commitment to see the process through to the end. And something else is needed: the best and the most comprehensive counseling support available.

What is the purpose of counseling in an open adoption? Initially, counseling plays a major role in avoiding the most obvious tragedy: the birthparents taking their child back after the baby is in the adopting couple's home. Without sufficient counseling, twenty to twenty-five percent of adoptions can end this way. Fortunately, with the IAC's counseling program the figures are different: typically fewer than five percent of counseling-centered adoptions end that sadly.

Yet, a truly successful adoption needs to go further, much further. Becoming a parent is not a one-shot affair; parenting is a commitment for the rest of a person's life. What is important is not just the presence of a baby in the couple's lives, but the general quality of their life as a family. The events around the birth of a child have a profound impact on parenting and childhood. Even if the birthparents do not back out of the adoption, if the birth and adoption process are filled with anger and distrust, the damage can be severe. The anguish of that experience can easily spill over to the adopted child and damage their delicate and critical opinion about their biological origins. Given the delicacy and complications of pregnancy, birth and delivery, infertility and adoption, such positive outcomes are not a matter of course. They require the extensive support of experienced and caring counselors throughout the adoption process.

But why is there so much emphasis on counseling? Many people assume that counseling is necessary only for people with severe emotional problems. But counseling can have a different meaning. The role of many counseling professionals today is not to deal with deep psychological problems. Often the focus is on helping men and women deal with specific, critical times in their lives, typically on a short-term basis. The role of adoption counseling is similar; it is not to solve anyone's neuroses. The goal is to help people successfully handle the high levels of stress inevitable in almost any adoption. Becoming a parent, even under the best of conditions, is an intense experience. And adoption is not the easiest of conditions. A certain amount of complication and uncertainty is inherent even in the most secure of adoptions. A comprehensive counseling and support program is vital to a truly successful adoption.

Counseling Support for the Birthparents
Birthparents not only have the physical, hormonal, and emotional concerns typical in any pregnancy, but also, almost invariably, deep feelings of doubt and loss related to their decision to have their baby adopted. Here, a comprehensive counseling program can ensure that the birthparents receive both support for their adoption decision and help enduring and understanding the pain and grief that accompany it. A well-designed counseling program can help the birthparents explore their past life, their plans for the future, and their motivation for making their decision. Often the most important function of the counselor is far less formal. They are there as a friend to the birthparent, a friend who understands both the birthparents' courage and their pain.

My family was involved with me in the adoption, but they really didn't understand how I felt. Their support was just not the same as what Gail and Eileen [the open adoption counselors], and especially the other birthmothers in our support group, could give me. They really let me see that I was making the right decision.

This close connection between counselor and birthmother or birthfather can be critical. For instance, it is not unusual for a birthmother—a few weeks before the baby is due—suddenly have doubts about her adoption decision. She may even wonder if she has picked the best couple to raise her child. Given the finality and enormity of her decision, such last minute questions are not surprising or abnormal. But what happens to these feelings? If nothing is done, the adoption may soon be in doubt. Yet, she is unlikely to call the attorney handling the adoptions for fear that he or she will threaten her with some type of legal action. She could talk to the adopting couple about her concerns, but the patience of a Saint would be required on their part to patiently hear what she does not like about them. What a birthmother needs most at that point is to talk with a trusted counselor. Her counselor can reassure her that these doubts are normal and help her remember why she chose this particular couple in the first place.

For many birthmothers, their most difficult moments come a few weeks after the birth of their child. With the help of the adoptive parents and their own friends and family, she may have been able to get through the birth itself. But, a few weeks later, her baby is gone, her hormones are running amuck, and the lifelong impact of her decision starts to come home to her. She is experiencing a deep sense of loss and grief. Most people feel that depth of pain only with the death of a relative or friend. But in those situations, there is nothing they can do to bring the deceased person back to life. In an adoption, in contrast, the birthmother can bring the lost person back. She can ask that her child be returned. Most reclaims—where the birthmother changes her mind and decides to parent the baby—occur at this point if the birthmother (and even the birthfather) do not have access to an experienced counselor to help with their intense sense of loss.

When this grief and pain hits, most birthparents feel too vulnerable and scared to call for help except for someone with whom they have already developed a close and trusting relationship. They are unlikely to call an attorney since that relationship is usually so formal nor even a counselor with whom they have had only limited contact. Here, in particular, the importance of establishing a close and continuing connection between counselor and birthparent early in the adoption becomes apparent.

The Center's staff recommended counseling but Leslie [our birthmother] felt she didn't need it. She knew what to do and she was feeling right about it. Her attorney felt that she had a family support system and that she was clear about her decision. So, Sean and I accepted Leslie's decision. That was a terrible mistake.

Soon after the baby was born, Leslie asked for the child back. We cared for her, we understood how she felt, but we were heart-broken. I believe that an established relationship with a counselor could have provided Leslie with the added strength that a birthmother needs to survive during this very emotional experience. A pre-established relationship can build a trust that is essential during the period of crisis. We had been encouraged to pursue Leslie's counseling needs, but we were naive and underestimated the importance of this service. No matter how strong or logical the birthmother is during that hour of giving birth, she needs professional support.

Counseling for the Adoptive Parents
For many people, their years of infertility have sapped their energy and made them pessimistic and cynical about ever becoming parents.

Not only did we not look like Ken and Barbie, but we also did not look like parent material at all. Parents are smiling people with babies, not gloomy people hopelessly giving each other fertility hormone shots and spending half their lives at the hospital having infertility surgeries.

Couples often bring those emotions to the adoption process. With adoption, they are once again being asked to risk a considerable amount of time and money. But why should they believe that the adoption path will succeed when other alternatives have not worked? Why would some birthparents, somewhere, ever select them to be the new mother and father of their child? How could they ever trust the birthparents to carry through with their promise to have them adopt their child?

Fortunately, a strong counseling support program can help adoptive parents overcome these problems. To start with, a counselor can guide the couple in working through the general pain of their infertility and restoring their lost self-esteem. Being part of an adoption support group—made up of other prospective adopting parents—can be instrumental in restoring their energy and enthusiasm. Simply seeing that other people have similar concerns and frustrations can be surprisingly comforting.

Eventually, most couples are contacted about a particular set of birthparents. But, then, how do they decide whether to work with these young people? For most adopting couples, these are the first birthparents they have encountered. Besides, the adoption process is often so emotion-laden that being objective is difficult. Here the counselor, as a caring yet impartial intermediary, has an important role to play. At the match meeting, the counselor can pose the difficult questions that everyone else may be too hesitant or too embarrassed to ask.

Though we had been with the birthparents all weekend, we were just too shaky to ask many questions. When the match started, though, Gail, our counselor, just started asking the questions, and it all seemed natural. We were relieved that she was asking them and that we were getting answers.

Afterwards, the counselors can help both the adopting parents and birthparents decide if the match is right for them. They can provide the adopting parents with an assessment of the potential success of the adoption based on their professional experience with similar situations.

Sometimes the prospective adoptive parents and birthparents are a mismatch. But saying "no" in these situations is not easy for anyone. Given how anxious prospective adoptive parents are about finding a baby, turning down any opportunity is not easy, no matter how unsuitable. A counselor can support the adopting parents in making the decision they need to make, even if the consequences seem dire at the time. Perhaps what they need is reassurance from the counselor that they will have other opportunities to adopt.

Once a suitable match is found, a comprehensive counseling program becomes important as a source of support for the adoptive parents and to provide mediation in case of any misunderstandings between them and the birthparents. Though a strong tie typically develops between adopting parents and birthparents, the bond is a delicate one. Everyone needs to feel respected and appreciated, but this sense of comradeship can be difficult to maintain.

Counselors are critical at the birth itself, where emotions are likely to be running high. The most effective counseling in this situation often comes from a counselor who not only has experience with open adoption, but also understands the special dynamics of hospital settings. Familiarity with the hospital's procedures and regulations can enhance the counselor's ability to help make the birth a wonderful experience for all parties.

For those adoptive parents whose adoptions fail, counseling support is obviously vital. The counselors—and other adoptive parents—can assist the adoptive parents through the necessary grieving process about the lost child and, at the same time, help them rebuild their hopes and strengths for another attempt to adopt.

We met with a counselor at the Center. She told us that our reactions were normal. She supported our decision to search for another birthmother. She helped us to recognize the grieving process we were going through and to gain strength from each other. The key to our healing was discovering why we were hurting so much. Jose and I came to the conclusion that our grief was mainly about losing the opportunity to parent. We needed ways to recapture this dream. It was clear we needed a child to help heal our pain. Our hope began to bloom.

Finally, there are important counseling concerns even after the adoption has been completed. Though ongoing relationships between adopting parents and birthparents are usually quite carefree, there can be misunderstandings. In such cases, the adoptive family can call on the support of the counselors who have been involved in their adoption since the beginning.

Our relationship with our birthmother has recently gotten much better. A turning point came a couple of weeks ago when we met with Kelly and the counselor who handled our adoption. She helped us work through some things that were keeping us from having a close relationship. She [the birthmother] got to tell us all her deep worries about us, and we told her what concerned us. That all seemed to help a lot. She clearly wants to have a continuing relationship with us and we want that, as well.

What Role, Then, Should Lawyers and Doctors Plan in an Adoption?
There is clearly a place for competent lawyers and caring doctors in an adoption. For some people, there is even a certain appeal to having an adoption handled exclusively through an attorney. Using an attorney can be expensive, but all that seems required is filling in a few papers and paying the legal bills. There are no workshops, counseling concerns, or extended relationships with birthparents. Yet, though legal and medical issues are important, they are generally less critical than emotional concerns in an adoption. Some attorneys do offer some limited form of counseling help: perhaps a counselor "on call" or limited help through the attorneys office. But adoption is such an intense process that such "only in an emergency" assistance simply fails to meet the needs of either adopting parents or birthparents.

An adoption can be such a source of joy when the right type of support is available.

Thank you all so much for your support, help, and education. We have you to thank for our sensitivity to our birthparents. We never could have gone through the independent adoption process without you.

Your counselor was so compassionate and caring about everyone's interests. She helped turn an amazing sequence of events into extraordinary episodes that were rewarding for all of us. We had a rare experience because you honestly care about the people seeking your service, and we are grateful.

The only thing we were not prepared for was how happy we would be with our little baby girl. What a joy!"

Excerpts from The Open Adoption Book: A Guide To Adoption Without Tears, by Bruce Rappaport, MacMillan, 1992

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