Understanding Options Counseling Experiences in Adoption: A Qualitative Analysis of Birth Parents and Professionals

The Donaldson Adoption Institute (DAI) has long since worked to explore and better understand the experiences of all members of the extended family of adoption. Through our works in areas impacting expectant and birth parents, we in particular hope to provide a platform for the voices of those who have long since been marginalized within the wider adoption discourse. DAI is excited to release our latest work in this area, the second study in our comprehensive options counseling research: Understanding Options Counseling Experiences in Adoption: A Qualitative Analysis of Birth Parents and Professionals. Building on the work that was released last November, this second phase provides for in-depth interviews with birth parents as well as adoption professionals to better understand their experiences as well as the context in which services are offered to expectant and birth parents. The findings reveal a variety of areas for improvement in both practice and policy. Furthermore, understanding the individual experiences in adoption allows for education of the wider community and will undoubtedly serve to create a healthier and stronger extended family of adoption.

The experience of an unintended pregnancy is rife with many complex feelings and emotions as well as a multitude of physical and hormonal changes. Given the vulnerability inherent during pregnancy, it is paramount that women who wish to explore their options surrounding a crisis pregnancy are provided with unbiased and comprehensive support surrounding the full range of options available. In order to provide effective services in this area, professionals who work with expectant parents must be well aware of both the policy and practice parameters that dictate ethical services in options counseling. Yet, DAI’s studies reveal that the framework surrounding options counseling practice lacks uniformity and can be inconsistently applied. Further complicating matters is that well-intentioned professionals’ express confidence in their ability to communicate effectively and comprehensively with expectant parents. However, birth parent perceptions revealed in this study show that many experienced confusion surrounding the full range of options available as well as a general lack of support. Of particular concern is that many mothers reported a lack of discussion surrounding parenting options or access to women who had considered adoption but had ultimately chosen to parent.

In terms of support, many of the birth mothers interviewed expressed a dearth of support from family and friends which impacted their decision-making in many ways. Of the mothers who expressed feeling unsupported, many described a sense of shame and social stigma that led them to feel judged because of their circumstances. Moreover, many mothers reported feeling pressured by family, and sometimes by professionals, to “choose” adoption instead of considering other options in their situation.

Although some mothers in this study felt assured that they had made the best decision possible at the time in relinquishing their parental rights to adoption, the majority expressed some level of regret which was further complicated when they realized the lifelong impact of their decision. For the women interviewed, many felt the general lack of discussion surrounding the lifelong impact of adoption while they were expecting and the absence of comprehensive support after relinquishing has negatively impacted them.

Ultimately, this study continues to support the need for a variety of changes to practice and policy in order to ensure the greatest support for women and couples experiencing an unintended pregnancy and to ensure they can arrive at an empowerment-based decision surrounding their pregnancy. These changes to practice and policy include, among other areas, the need for uniformity in the provision of options counseling services, including the minimum number and type of counseling sessions; avoiding dual roles for service providers who work with prospective adoptive parents as well as expectant parents; ensuring practitioners are well versed in the availability of the full range of options for women in a crisis pregnancy; and ensuring an appropriate time frame after the child is born for women to re-evaluate their options before surrendering their rights. Additional recommendations are included in the full study.

This research was led by Dr. Elissa Madden, PhD, Assistant Professor at the Diana R. Garland School of Social Work at Baylor University and Dr. Scott Ryan, PhD, Dean and Jenkins Garrett Professor at the School of Social Work at The University of Texas of Arlington. Additional researchers include Dr. Donna Aguiniga, PhD; Olga Verbovaya, MSW; Marcus Crawford, MSW; and Chandler Gobin, BA. This project was underwritten by DAI’s Lynn Franklin Fund with initial funding by James Stevens. Brenda Romanchik (LCSW, ACSW, CTS and author of A Birthparent’s Book of Memories and other publications) served as the Project Lead. The Lynn Franklin Fund Advisory Council provided invaluable insight throughout this project.

Later this month, DAI will host a panel discussion at the Silberman School of Social Work at Hunter College, which will include a discussion of the research as well as experiences in adoption through the lens of women’s rights. To learn more and register to attend this free event, please visit “Women, Family and Adoption: Reclaiming our Narrative.”

Providing options counseling services to expectant parents is a critically important process. It is essential that services are offered in a way that ensures the client’s self-determination and are structured within a framework of a strengths-based, empowerment practice. Practice in this area should not lead any expecting parent to one particular outcome; rather services should be geared towards supporting parents in making decisions that are fully informed and represent their choice for what they believe to be the best solution for themselves and most especially their child.


Since 1996, The Donaldson Adoption Institute has been on a mission to improve the lives of children and families through research, education and advocacy. We investigate the issues of greatest concern to birth families, adoptive/foster families, adopted people, the people who love them and the professionals that serve them. We educate and train professionals, enlighten parents and engage members of the community to make a positive impact on laws, policies, practices and perceptions.


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