Barriers to Finalization: Why are Some Adoptions Never Completed?

Introduction

This article summarizes findings from a study of barriers to finalizing adoptions for prospective adoptive parents (PAPs), identified by a research project initiated and funded by Gift of Adoption (GOA), a national nonprofit organization whose mission is to provide assistance grants to complete the adoptions of vulnerable children. Between November 2022 and March 2023, GOA, in collaboration with National Council For Adoption (NCFA), collected online survey data from 156 adoption professionals and 75 prospective adoptive parents in the United States. Participants provided information about different types of adoptions and various factors influencing the outcomes of the adoption process. Data was analyzed statistically and thematically. Findings revealed the most significant obstacles to be financial barriers and cost, difficulty with the adoption process, concerns for children’s behavioral needs, and changes in children’s availability for adoption. Limitations and areas for further study are discussed. The results can be used to inform future research and assist adoption professionals in their service to families in the process of adopting.

Background

In 2022, there were over 106,000 adoptions of children in the United States. That figure includes stepparent adoptions, with non-stepparent adoptions making up an estimated 80,598 of that total.[1] According to the U.S. Department of Health and Human Services’ Children’s Bureau, a point-in-time count from September 2022 showed that there were over 368,000 children in foster care in the United States, the majority of whom (52%) had a goal of reunification, while 28% (approx. 101,000) had a goal of adoption.[2] Of the more than 80,000 non-stepparent adoptions in 2022, foster care adoption was the most common type, making up 66% of the total (est. 53,579).[3] Private domestic adoption is the next most common type, making up 32% of adoptions in 2022 (est. 25,503 total).[4] This figure excludes stepparent and embryo adoptions, which comprise approximately one-half of private domestic adoptions.[5] Most private domestic, non-stepparent adoptions involve infants. International adoption, by contrast, made up only 2% of adoptions in 2022 (1,516 total).[6]

As a result of the continued practice of adoption, many people in the United States are directly or indirectly impacted. The 2022 U.S. Adoption Attitudes Survey found 40% of adults surveyed reported knowing friends or family who have been adopted, and more than half of respondents reported knowing a relative or friend who was adopted from the foster care system.[7] This same study also revealed 2 in 5 adults (37%) said they have considered adopting a child, and about 25% of those respondents reported very seriously considering adoption.

The 2022 U.S. Adoption Attitudes Survey also detailed misconceptions and misperceptions of adoption, as well as specific perceived obstacles to adoption.[8] For example, the most recent survey revealed the public perception that the cost of adoption is increasingly very expensive for all types of adoption. Other concerns identified by adults in this survey include coping with behavioral issues, receiving adequate post-placement support, quality of professional services, birth/first family involvement post-adoption, and navigating bureaucracy. For those considering foster care adoption, financial support for a child’s emotional and physical needs, as well as counseling services and support groups for both the child and parents/family, would make a difference in the decision to pursue adoption.

NCFA’s Profiles in Adoption study, which surveyed those who had completed adoptions, also found that, prior to completing an adoption, 51% of adoptive parents surveyed believed cost was a barrier.[9] This study reported that, since 2010, the average adoption cost was $33,141 for private domestic adoption and $36,776 for intercountry adoption.[10] Most families who adopted from foster care obtained adoption assistance (i.e., subsidies), which averaged $601/month.

A previous analysis of the impact of state financial subsidies for foster care adoptions found that financial support reduces barriers and promotes foster care adoptions.[11] In fact, state financial assistance for foster-to-adopting families was 10 times more effective in increasing the adoption rate than the same amount of money invested directly in foster care services.

This 2022 study focused on perceptions of prospective adoptive parents who started but did not complete one or more attempts to adopt. This study also invited adoption professionals to describe the reasons prospective adoptive parents begin but do not complete adoptions.

Methodology

In 2022, GOA collaborated with National Council For Adoption (NCFA) to develop, deliver, and analyze two online surveys: one for adoption professionals and one for prospective adoptive parents (PAPs) who began but did not complete an adoption. The goals were to better understand the reasons PAPs do not complete adoptions, to identify barriers to adoption, and to identify opportunities for addressing and overcoming those barriers. Participation was limited to people over 18 years old who live in the United States.

Participants were recruited via email and listserv invitations to NCFA and GOA networks. Participants followed a link in these messages to review and complete a one-time survey focused on their respective experiences with incomplete adoptions. NCFA distributed the survey link to a listserv of 381 unique email addresses of adoption professionals at approximately 100 adoption agencies, and an additional 15 adoption attorneys. The final sample consisted of 156 adoption professionals and 75 prospective adoptive parents. As an incentive, NCFA offered $20 gift cards to the first 25 prospective adoptive parents who fully completed the survey.

GOA and NCFA contracted Phil Weglarz, PhD, as an independent researcher to manage the survey instrument, analyze results, and create a descriptive report of research and findings for GOA and NCFA. As core faculty at the California Institute of Integral Studies (CIIS), a university in San Francisco, Dr. Weglarz submitted the study design for review by the CIIS Human Research Review Committee, which provided feedback and approval prior to data collection.

Data were analyzed statistically and thematically. Data collection and analysis were reviewed and discussed by a team of representatives from GOA and NCFA.

Results

Prospective Adoptive Parents

Between 2/15/2023 and 3/18/2023, 81 people responded to the prospective adoptive parent survey. Six responses were removed from the analysis because they did not meet the inclusion criteria as prospective adoptive parents who did not complete one or more adoptions. The resulting 75-person sample was considered adequate for a first-of-its-kind survey and was believed to demonstrate a desire of those with this experience to be heard.

Participating prospective adoptive parents were predominantly White and married, under 40 years old, who reported annual household incomes under $100,000, and with college educations. Eighteen percent of participants identified as Black or African American, Hispanic or Latino, or multiracial. Eight percent reported being single. Twenty-five percent reported being over 40 years old. At the time of the survey, over 83% of respondents were the parents of one or more children. Half of the respondents were parents of children who were adopted and who attempted a subsequent adoption that was not completed. The other half have never completed an adoption. Thirty-two percent of respondents were currently or had been foster parents.

Motivation to Adopt

Respondents reported their primary reasons for pursuing adoption being “provide a permanent home for a child” and “infertility,” followed by “extend family” and “give child a sibling.” The vast majority also reported being “very interested and committed” and initiating the adoption process through an agency, as well as working with social workers, adoption specialists, lawyers, and in a few cases, private adoption facilitators.

Adoption Attempts

Prospective adoptive parents represented a range of adoption attempts. The majority of respondents reported incomplete adoptions in the context of private agencies (57%), followed by foster-to-adopt/public adoption (15%) and international adoption (13%). In most of the reported cases of incomplete adoptions, the PAPs had no prior relationship with the child or the child’s expectant/birth/first parent(s). In a small number of cases, the child was known through a friend, friend of a friend, or relative; was the sibling of a previously adopted child; or was the family’s foster child. Similarly, in each of those cases, the child’s expectant/birth/first parents were known to the PAPs through a friend or friend of a friend, as the birth/first parent of a previously adopted child, or as a relative. In most of the reported cases, the child who might be adopted was either not yet born/in utero or an infant to two years old. Some children were older, including those two to five years, six to twelve years, and thirteen or older. Some respondents reported a number of additional details about the children involved, such as different race/ethnicity than PAPs, behavioral special needs, physical disabilities, sibling set, and parental substance use disorder or prenatal drug exposure.

Reasons for Not Completing Adoptions

The most frequent reason given (30%) by participants for not finalizing an adoption was because the expectant/birth parent decided not to proceed with the adoption plan. Other reasons included that the adoption process was too chaotic, the costs exceeded means/financial circumstances, concerns about legal risks, concerns about supporting a child’s behavioral needs, changes to personal circumstances, and the placement/matching process took a long time. Other, less frequently cited reasons included lack of information, lack of progress in courts, child(ren) reunified with first/birth family or placed elsewhere, world events (e.g., COVID-19 pandemic), becoming pregnant, concerns about open adoption, and insufficient post-placement services offered. None of the respondents reported that adoptions were not finalized due to concerns related to supporting a child’s racial/ethnic identity development, not being approved for adoption, or the child not wanting to be adopted.

Expenses as a Barrier

When asked directly about adoption expenses, 97% of prospective adoptive parents (PAPs) said cost was a barrier, with 48% saying it was an “extreme barrier.”  PAPs at all income levels rated the cost of adoption an “extreme barrier.” Significantly, only four respondents reported receiving any type of public assistance at the time of the uncompleted adoption, two of whom received a foster care subsidy, and one each of Social Security and Medicaid. However, the majority of respondents reported that the cost of raising an adopted child is “not a barrier at all.” In follow-up questions directed to those who attempted to adopt from foster care, respondents identified out-of-pocket expenses (e.g., TB tests, home inspections, fire inspections, fingerprinting, etc.) as a minimal/minor barrier, whereas the costs of adapting a home for placement (e.g., adding bedrooms, windows, fencing, etc.) was a minor/moderate barrier. When asked about intent to attempt a subsequent adoption, most respondents, across income levels, said “Yes,” although those in the $100-150K annual income bracket were more likely to reply “Maybe/Not Sure” or “No.” In open text responses asking participants to describe the kinds of support or resources that would have been most effective to overcome barriers to completing the adoption process, 33 of 50 comments identified financial concerns.

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When asked directly about adoption expenses, 97% of prospective adoptive parents (PAPs) said cost was a barrier, with 48% saying it was an “extreme barrier.” 

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Adoption Professionals

Between November 28, 2022 and December 9, 2022, 156 adoption professionals representing a range of roles, years of experience, and the type of adoption they focus on responded to a 12-question online survey. This group identified the following as the most common reasons that prospective adoptive parents did not complete the process: placement/matching process took a long time, personal circumstances (e.g., a move, illness, divorce, etc.), prospective adoptive parents became pregnant, and financial circumstances. Less prominent reasons included adoption not approved (prospective adoptive parent not approved and/or discouraged from proceeding), concerns related to supporting adoptive child's behavioral needs, child(ren) reunified with first/birth family or placed elsewhere, world events (e.g., impact of COVID-19 pandemic), child(ren) did not want to be adopted, cost exceeded means (e.g., unexpected legal fees in contested adoption), lack of information, concerns relating to supporting child’s racial/ethnic identity development. Some adoption professionals also included additional reasons, such as ambivalence, unrealistic expectations, disunity among spouses, their extended family did not support the adoption, and state-specific issues.

The barriers identified by adoption professionals differed by type of adoption. Professionals focused on foster care adoption were more likely to raise concerns about the child’s behavioral support needs. For both private domestic adoption and intercountry adoption, professionals were more likely to identify the long timeframe it takes toward a placement. For kinship adoptions, professionals often identified the reason a placement did not occur was due to a child being reunified with their birth family.

Adoption professionals were also asked to comment upon prospective adoptive parents’ degree of commitment and associated behaviors. The vast majority of professionals rated PAPs as being “committed” or “very committed.” Behaviors associated with high levels of commitment included completion of required paperwork, paying required fees, frequently asking questions, and attending training sessions. Adoption professionals identified financial resources, information, and communication as the most effective supports in overcoming barriers to finalizing adoptions.

Key Findings

• Financial Barriers/Adoption Cost – Both adoption professionals and prospective adoptive parents identified the cost of adoption as a barrier. Adoption professionals cited financial circumstances as one of the top four reasons an adoption may not be completed. When asked directly about adoption expenses, 97% of prospective adoptive parents (PAPs) said cost was a barrier, with 48% saying it was an “extreme barrier.” PAPs at all income levels rated the cost of adoption an “extreme barrier.” Adoption professionals suggested lower fees and increased financial support, like grants and more effective tax credits.
• Difficult Process – Participants identified several characteristics of the adoption process that became barriers to completion: it takes a long time, is too chaotic, and they needed more orientation/information. Adoption professionals reported the primary reason prospective adoptive parents did not complete adoptions was because the process took a long time. Professionals suggested that PAPs who are better informed and engaged are more successful in navigating the process and have realistic expectations. PAPs also expressed a desire to improve orientation and education, as well as increase transparency of circumstances and policies.

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Both adoption professionals and prospective adoptive parents identified the cost of adoption as a barrier.

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• Child’s Behavioral Needs – Professionals reported that some PAPs withdraw because of concerns related to supporting the adoptive child's behavioral needs. This concern was most prominent among PAPs who attempted to adopt from foster care or internationally. Professionals mentioned how a lack of information relates to the other responses regarding unrealistic expectations. As one professional put it, “Setting realistic expectations with families before they contract with an agency is key.” Several other professionals described the need to educate PAPs about the current state of adoption practice and the needs of children waiting to be adopted.
• Changes in Child’s Availability for Adoption – While circumstances varied, reasons related to the child no longer being available for adoption were seen across groups. Many PAPs involved in private domestic adoptions reported that the process was not completed because expectant parents chose not to proceed with the adoption plan. Others reported being involved with international adoptions where the sending country ceased adoptions. In some foster-to-adopt/public and/or kinship adoptions, children were reunified with their first/birth family or placed elsewhere. When PAPs bear the financial burden of an incomplete adoption process, they may not be able to afford a subsequent attempt. When asked if they intend to attempt to adopt in the future, those in the middle-income levels, between $75K - $150K/year, were more likely to reply “Maybe/Not Sure” or “No.”

Limitations

Although each survey shed light on multiple dimensions of professional and PAP experiences of incomplete adoptions, the findings of this inquiry are limited by two factors: relatively small sample sizes and restricted timeframe.

The two samples are distinct and pose challenges to comparison. About twice as many professionals responded to the survey relative to the number of prospective adoptive parents. Further, in understanding the study, we recognize the variance in responses by adoption type, so rather than looking at variances by the responder (professional vs. PAP), we suggest looking at responses by adoption type: private domestic, international, foster-to-adopt/public, and kinship.

While the sample size is relatively high for a sensitive topic, the sample of PAPs is rather homogenous: predominantly White, married couples under 40 years old, whose annual household incomes are less than $100,000, with varying levels of education, who were pursuing private infant adoptions. In open-text responses, two PAP respondents identified a need for diversity, equity, and inclusion (DEI) related services, including support groups for gay dads and “more services and connections for minorities who are adopting.”

Future Research

Building from the findings in this study, adoption agencies could begin tracking the reasons why families do not complete adoptions. If they do not have a formal method of monitoring this, they can begin by asking basic questions about the reasons why an adoption process was begun but not completed. Over time, an agency can use this data to evaluate their practices and look for opportunities to improve service provision, with the goal of limiting the number of instances where PAPs begin but do not complete an adoption.

Additionally, future research can evaluate programmatic responses to adoption barriers. An example might include examining the impact of financial support on families’ abilities to complete their adoption processes.

Conclusion

This study provides a qualitative, in-depth perspective on specific issues from adoption professionals and PAPs in their own words. While there are sampling differences, the findings of this research project are generally consistent with other adoption studies, such as NCFA’s Profiles in Adoption survey and the Dave Thomas Foundation’s Adoption Attitudes Survey.

The findings can be used by adoption professionals to help prepare PAPs considering adoption, as well as by grant-making organizations and others who want to encourage and support adoption processes through to completion.