Adoption FAQ for Hospital Professionals

As a leading national adoption agency, American Adoptions completes hundreds of adoption placements each year. We work with hospitals on a daily basis to support women and families through this process.

As such, we often receive questions from hospital staff about adoption: how the legal process works, the choices women have when considering adoption, the resources that are available, and more.

In this guide, we’ve provided answers to some of the most commonly asked adoption questions from hospital professionals, so you can be better prepared to support prospective birth parents and adoptive families.

If you need to speak with someone about an adoption plan for one of your patients, you can call us any time at 1-800-ADOPTION to speak with a licensed social worker who specializes in adoption.

We are always happy to answer any questions and support you and your patients in whatever way we can.

A Prospective Birth Mother’s Choices and Resources

Some of the most common adoption questions from hospital staff stem from basic curiosity about how the process works today. Adoptions look very different than they did just 10 or 20 years ago.

Sometimes, hospital staff will be wary of adoption because of preconceived notions of how this process used to work.

The truth is, today’s adoptions put prospective birth mothers in charge. Women today have more choices and resources than ever before. This is a process that empowers expectant mothers to make a plan that they feel is best for their baby.

Below are answers to common questions about a mother’s choices and available resources during the adoption process.

Can the prospective birth mother pick the adoptive family?

Yes. The prospective birth mother always has the opportunity to choose the adoptive family she wants for her baby. This is 100% her decision.

Whether she makes an adoption plan early in her pregnancy or contacts American Adoptions after she’s admitted to the hospital, she has the right to choose the perfect adoptive parents for her baby.

American Adoptions works with expectant mothers to understand what they’re looking for in an adoptive family, including details such as:

Using this information, we will provide adoptive family profiles who match that ideal family the prospective birth mother is looking for. She can look at as many profiles as she’d like to find the perfect adoptive parents for her baby.

After that, she can get to know the adoptive parents further through phone calls, email, and even in-person meetings, so she can feel confident she’s picking the absolute best family for her child.

It’s worth noting that not all prospective birth mothers want to choose the adoptive parents. American Adoptions respects this decision and can select an adoptive family on behalf of the potential birth mother based on any desires she has for an adoptive family.

Can the prospective birth mother pick the level of contact in her adoption?

Yes. It is always up to the prospective birth mother to decide what kind of relationship she wants with the adoptive family and her baby.

All of American Adoptions’ families are committed to, at minimum, a certain level of open adoption contact, which includes ongoing phone and email contact and at least one post-adoption visit.

However, potential birth mothers can always decide whether they want more or less contact. Adoption contact can range from a closed adoption, in which very little to no ongoing contact is shared, to a fully open adoption with regular phone calls, video chats, text messaging, visits and more.

Whatever a prospective birth mother is looking for in this relationship, American Adoptions will help her find adoptive parents who want the same level of contact with her.

Can the prospective birth mother make changes to her adoption hospital plan?

Of course. Many prospective birth mothers will come to the hospital for delivery with an established hospital adoption plan. However, it is common for a woman’s preferences to change after she arrives at the hospital during what can be an emotional and hectic time.

For example, a prospective birth mother may initially feel that she does not want to spend time alone with her baby, but later decide that she does want to have that important time to bond.

This is normal and does not necessarily mean that the prospective birth mother is going to change her mind about her decision to place her baby for adoption. It’s perfectly okay for a prospective birth mother to change her mind about the details of her hospital plan.

Remember, a woman considering adoption maintains all legal rights and responsibilities for her baby until she has signed adoption consent forms. Hospital staff can support prospective birth mothers by staying flexible and respecting this hospital plan, even as it changes.

Is it normal for a woman to question her adoption decision at the hospital?

Yes. This is a big, life-changing decision that involves a number of complicated and conflicting emotions. Almost every prospective birth parent will waver and experience moments of doubt during the pregnancy, at the hospital and even after the adoption takes place.

A woman may go back and forth on her decision several times before ultimately making the choice that is best for her.

Prospective birth parents receive ongoing counseling during and after the adoption to help prepare them for these moments of doubt and ensure they are making the decision they truly feel is best for them.

These moments of doubt can be stressful for adoptive parents and hospital staff, but they are completely normal. While a percentage of women ultimately will change their mind at the hospital and decide to parent, most prospective birth mothers will continue with their adoption plan.

However, up until signing the legal adoption paperwork, every potential birth parent has the right to change their mind about the adoption process.

Can a prospective birth mother talk to another woman who has placed a baby for adoption?

Yes. American Adoptions can refer prospective birth mothers to other women who have placed their baby for adoption and are willing to discuss the experience in more detail.

To get in touch with a peer counselor, prospective birth mothers can call 1-800-ADOPTION or request more information online. 

Women can also talk to Michelle, a birth mother specialist with American Adoptions who placed her own son for adoption. To ask Michelle an adoption question directly, click here.

What other resources are available for women considering adoption?

There is no shortage of information and resources available to women considering adoption, including:

• Testimonials and adoption stories from other women who have placed a baby for adoption

• American Adoptions’ YouTube channel, which includes adoptive family video profiles, informational videos for prospective birth parents, and adoption stories from real birth mothers, adoptive families and adoptees

• BirthMotherThoughts.com, an informational website for prospective birth mothers, written by birth mothers

• AdoptionAgencies.com, which provides general information on adoption agencies and how to choose a professional, as well as listings of adoption agencies by state and city

• Ask Michelle, a feature on the American Adoptions website that puts women in touch with Michelle, a birth mother and adoption specialist

Questions About Hospital Adoption Policies

Because most private domestic adoption placements happen in the hospital shortly after birth, hospital staff — including nurses, physicians, hospital social workers and admin staff — play a vital role in the process.

Prospective birth mothers’ and adoptive families’ experiences at the hospital can leave a lasting impression and make an impact on their overall adoption experience.

As a leading national adoption agency, American Adoptions often hears questions from hospital staff about what they can do to create adoption-friendly hospital policies.

What can we do to improve the hospital experience for clients going through the adoption process?

There are several changes hospitals can make to their adoption policies to better support prospective birth and adoptive parents, including:

• Establishing an internal notification system to quickly and discreetly alert hospital staff to a patient’s adoption plan. Have something in place to allow hospital staff to know that a woman is considering adoption without having to ask her (for example, place an inconspicuous, color-coded sign on the hospital room door, place a certain color of flowers or balloons in the room, etc.) This will notify all hospital staff of the adoption situation so they can be sensitive to the patient’s specific needs and emotions.

• Make accommodations for the adoptive family as available, such as providing them with a separate room to bond with the baby (as space allows), providing wristbands to allow the adoptive parents to visit the baby in the nursery (with the prospective birth mother’s permission), etc.

• Use positive adoption language. Educate all hospital staff on positive and accurate adoption language. For example, instead of “giving a baby up for adoption,” hospital staff should use the terms “making an adoption plan,” “choosing adoption,” or “placing a baby for adoption.” Small changes in language can go a long way in empowering patients and removing the stigma associated with choosing adoption.

These are just a few of the changes hospitals can make to their adoption policies to improve the experience for prospective birth mothers and adoptive families. For more information and ideas, see our Guide to Creating a Friendly Hospital Adoption Policy.

How should we protect patients' confidentiality during an adoption plan? 

As you know, patient confidentiality is critically important. The same is true when a woman is making an adoption plan. 

Adoption is a highly emotional decision, and one that can cause conflict in the lives of some prospective birth parents.

In many cases, prospective birth mothers will have made clear and conscious decisions about whom in their lives to tell or not tell about their adoption decision, as well as when and how they would like to share this information.

A woman considering adoption may choose to keep her adoption plan confidential from certain people in her life for any number of reasons.

Because of this, it is crucial not to disclose anything to anyone about a patient’s adoption plan without her express permission to do so.

Sometimes, well-meaning hospital staff will assume a prospective birth mother’s friends or family members are aware of her adoption plan and make comments that will inadvertently share this information before she is ready.

Other times, hospital staff will contact a third party, such as tribal authorities or other adoption professionals, without first consulting with the prospective birth mother or her adoption agency.

Not only does this violate the patient’s confidentiality, but it also undermines the adoption plan she may have spent weeks or months working on. 

Legal Adoption Questions

Adoption is a legal process, and adoption laws can sometimes be complex and difficult to understand. Women considering adoption can be connected with the legal counsel they need, for free, through an adoption agency like American Adoptions.

However, it’s still a good idea for hospital staff to have some basic familiarity with state adoption laws and the rights their patients have. Below, we’ve answered some of the most common legal questions we hear from hospital staff.

Please note that this information is not intended as and should not be considered as legal advice.

What if the patient’s family members disagree with her adoption decision? Do grandparents have legal rights to the child?

No. Many prospective birth parents face opposition from members of their family regarding their adoption decision.

However, as long as the mother is old enough to legally consent to the adoption (as established by state law), she is the only person who can make this decision, regardless of others’ opinions.

Hospital staff should defer to the mother’s wishes and hospital security policies when deciding whether to permit unsupportive family members to visit the mother.

What if the mother is a minor?

In most cases, a prospective birth mother can legally choose and consent to adoption, even as a minor. Every state law is different, but an adoption agency will set up the proper legal representation and get a legal guardian involved should that be required for the situation.

What about the birth father? What should we do if he shows up at the hospital against the mother’s wishes?

Different states and adoption professionals handle birth father rights very differently. In some cases, the birth father will be involved in the adoption process and will sign the adoption paperwork alongside the mother.

In these cases, he can be as involved in the mother’s hospital stay to whatever extent she feels comfortable. Hospital staff should defer to the mother’s wishes and hospital security policies when deciding whether to permit an unsupportive birth father to visit the mother.

When can prospective birth mothers sign adoption paperwork?

Many prospective birth mothers choose to sign their adoption consent paperwork at the hospital or shortly following discharge. Most states require a mandatory waiting period, often between 12–72 hours after birth, before adoption consents can be signed.

However, some states allow consents to be signed directly after birth, and others require a waiting period of up to one month.

This waiting period is designed to give the mother sufficient time to recover from labor and delivery so she can make a final decision about adoption with a clear mind.

Before she signs her consent to the adoption, her adoption agency will work with hospital social workers and a local attorney to ensure the prospective birth mother is confident in her adoption decision and that the adoption paperwork is completed legally.

What are Safe Haven Laws? How do they work?

Safe Haven laws protect babies who might otherwise be abandoned in unsafe conditions. Every state has Safe Haven laws that allow mothers to relinquish custody of their infants safely, anonymously and without facing charges of child abandonment.

The specifics of each state’s Safe Haven law vary; in most states, babies must be unharmed, must be within the state’s established Safe Haven age limit, and must be left with an on-duty staff member at an approved Safe Haven location.

Approved Safe Haven locations vary by state but often include hospitals, police departments, fire stations and other emergency service providers.

If a baby is left with an on-duty employee at your hospital, you should follow the steps outlined by your state’s Safe Haven law.

This may include administering any immediately necessary medical care and notifying law enforcement or the local child welfare department that an infant has been relinquished.

Does the prospective birth mother get an attorney for the adoption?

Yes. In most cases, the prospective birth mother will have an attorney separate from the adoptive family’s attorney to ensure her rights are protected.

Situations and state laws do vary, so this is not always possible in all situations. Feel free to contact us or inquire with your patient’s adoption agency if you have more questions about this.

What is ICWA, and what do we need to know?

The Indian Child Welfare Act (ICWA) is a federal law enacted to preserve Native American families, tribes and culture by governing foster and adoptive placements of American Indian children.

ICWA sets guidelines and requirements for how adoption agencies and the child welfare system serve tribal children and birth parents, giving tribes legal authority and a voice in child welfare cases.

There are a number of factors that determine whether ICWA applies in an adoption case, including whether the child being placed for adoption is a registered member of a federally recognized Indian tribe or is eligible to be a member of a federally recognized Indian tribe and the biological child of a member of the tribe.

If ICWA law applies to the adoption of a child born in your hospital, American Adoptions staff and attorneys involved in the case will work with you on any necessary actions that must be taken to legally complete the adoption. 

In many cases, attorneys and agency staff will have already determined whether legal action needs to be taken to satisfy ICWA, and will have already notified the tribe if necessary. It is rarely necessary for hospital staff to contact a tribe about an adoption situation.

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If you have additional adoption questions that were not answered here, or if you need to speak with someone about an adoption plan for one of your patients, you can call us any time at 1-800-ADOPTION to speak with a licensed social worker who specializes in adoption. We are always happy to answer any questions and support you and your patients in whatever way we can. 

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