Imagine if you heard that the child of a friend of yours had died. Maybe a baby was stillborn, a toddler had a terrible disease, a child was struck by a car. The parents would be devastated. There would be religious services, perhaps. There would be outpourings of sympathy. The parents would likely receive counseling and therapy, join support groups, and take much time to recover and heal.

Do we think the grief and despair are different for impoverished parents who place their children for international adoption? After handing over their child or children, oftentimes never to see them again, what happens? What support and counseling do they receive? The answer, for most, is none.

According to a master’s thesis from a student at Addis Ababa University, some 80% of Ethiopian birth parents suffered with moderate or severe depression after placing their children. Before placing their children, 5% reported receiving counseling about their decision.

After placement, what percentage received counseling services?

Zero.

That, to me, is unconscionable.

The Ethiopian birth parents cited in this thesis dealt with their grief and loss mostly through prayer and through talking with friends. Both of those responses are appropriate and can be helpful, no doubt. But, really, is that the best we can do for them? Leave them alone and isolated in their grief after forever losing a child?

Most of the Ethiopian birth families in the thesis research placed their children because of poverty. They reported average monthly incomes of below 200 Ethiopian birr, or about $20. Their children were not orphans. Unlike parents who have tragically lost their children to death, these parents chose to place their children for adoption, and to potentially lose them forever. But is horrific poverty really equivalent to having a choice?

One birth mother said:

I had no regular income at the time of relinquishment. I was a daily laborer. Starting at the last month of my pregnancy, I couldn’t continue to work as a daily laborer, and it was very difficult to get an employer who can tolerate a pregnant or nursing woman to do his/her work.  No one was willing to employ me. My only choice was to give the child for  orphanage or adoption both for the sake of the child and for my survival. However, deciding on relinquishment was not a simple matter. It was so painful.

Most of the birth parents discussed in the thesis were between the ages of 16 and 37;  31 were birth mothers and 11 were birth fathers. About 32% were married; the others were unmarried (40%), widowed (12%), or divorced (16%). All too often, birth fathers are not fully considered in adoption policy discussions. In this research, the average depression of male respondents was greater than that of female respondents.

A friend of mine is an adoptive parent of 2 young Ethiopian children, and is in contact with her children’s Ethiopian families. She shared this with me.

…our first visit with family at the orphanage post-adoption in 2010 was eye-opening because that’s when I first heard from the orphanage directors about first families desperate for news for their kids. And then when I followed up with an acquaintance that was an ex-agency employee, he said that he was contacted a lot by grieving first mothers. He said one repeatedly called him in the middle of the night crying and begging for information on her child. Good God. That’s even hard to type.

The first parents hope and cry for information. But all too often their voices are not heard. I doubt this reality is unique to Ethiopian first families. I am sure it resonates for Chinese, Guatemalan, Korean, Russian, and other birth parents as well.

How do the adoption agencies who placed the children  provide post-adoption services to international birth families?

Most agencies offer some sort of post-adoption resources in the US for adoptive families, though there is a great need for more. Therapists have practices that include adopted children and families. There are attachment centers, behavioral coaches, medications, and many other resources available, especially if the families have insurance and funds for them.

Where do post-adoption services for international birth families fall on the spectrum of priorities for adoption agencies? Are post-adopt services even on the list?

I don’t take adoptive parents off the hook here, either, including myself, though I recognize that follow-up with Ethiopian first families can be complicated for many reasons.

It’s just too easy, though, to close our eyes, ears, and hearts; to want to think positive thoughts about birth parents who made a loving decision; and to not want to think that our joys are built on someone else’s deep sorrow and abject poverty.

I’m convinced we can and must do better for birth families. We need to let go of fears.The possibilities include having hard conversations about loss and grief, taking deep breaths and thoughtful actions, and demanding transparency and equity in adoption.

My next post will include some concrete ideas about how we might do this.

(A note about the research on Ethiopian original families: there needs to be lots more. The thesis I cite in this post is available on Amazon for around $40, which to my mind is a lot of money for a 42 page slim book. I have not been able to find the thesis on-line. I have written before about 2 other master’s theses (available on-line) that provide research about birth parents. One is Research on Ethiopian Birth Families: A Must-Read. The other is Ethiopian Birth Mothers After Relinquishment: MSW Research from Addis Ababa University.)