If you’re just starting out, be prepared—you have many choices to consider. If you want to adopt in the United States, many options await. If you decide to go international, you’ll have many countries from which to choose. If you adopt domestically, the trend toward openness means you’re likely to meet the birthparents, who may request ongoing contact with the child. Regardless of where you adopt from, you’ll have the choice to adopt a child outside your race or ethnicity, which presents other parenting issues.

With more options come more decisions, each with its own emotional and financial risks and benefits. To help you get started, here is a guide to the most common routes to adoption.

Adopting via an adoption agency

People seeking a healthy, U.S.-born infant often enlist the help of an agency. Private agencies set criteria about whom they will serve, some more restrictive than others. In the past, those using an agency put their names on a list and waited for a match. Today, the agency is likely to send biographies of three or more sets of prospective adoptive parents to the birthparents, who pick the one they are most comfortable with. Then, the birthparents and adopting parents meet. At least half of the 15,000 or so domestic agency placements of infants each year involve such meetings. The child may be placed with the adopting parents immediately after birth or from foster care. If you insist on a closed process, your wait may be longer, since most agencies now encourage varying degrees of openness.

Typical Cost: $15,000 to $25,000, including the homestudy, counseling for birthparents and prospective adoptive parents, medical expenses, and foster care, if needed.
Benefits: If service and support are what you want, an agency makes the match and guides you through the process. Fees are typically predictable.
Risks: The agency’s criteria and the birthparents’ desires for adoptive parents, in addition to your own specifications for a child, can affect the time it takes for you to be matched with a birthparent. Birthparents who change their minds almost always do so before the birth.

Adopting an infant privately

The other common way of adopting a domestic infant is by locating a birthmother yourself, usually with a lawyer’s help. Of the estimated 30,000 annual domestic infant adoptions, at least half are done independent of an agency. Independent adopters mail résumés to obstetricians and attorneys, advertise in newspaper classified sections, even create home pages on the Internet. The baby typically is taken home directly from the hospital. Adoptive and birthparents together arrange a plan for the adoption and ongoing contact, if desired.

To mark the new year, Elise and Robert Sandiford of Los Angeles sent notes to their friends expressing their wish to adopt a newborn. A former neighbor in Chicago gave the letter to her rabbi, who passed it on to a pregnancy counselor in Colorado, who showed it to a teen client. The Sandifords met the teenager in Colorado, brought her back to California to live with them, and paid her medical bills, counseling fees, living expenses, and telephone bills. Three and a half weeks later, they were in the delivery room for the birth of their daughter, Kira.

Each state has its own laws governing independent adoptions, which are illegal in Colorado, Connecticut, Delaware, and Massachusetts. In some states, for example, an attorney can search for a birthmother for you. Or you can search on your own and use the lawyer to screen prospective birthmothers and handle the legal paperwork. A search can take six months to more than a year. In “identified adoption,” a hybrid of agency and independent adoption, adopters find a birthmother on their own but use an agency for services such as the homestudy and birthparent counseling.

Typical Cost: $7,000 to $9,000 in legal fees for yourself and the birthparents, plus at least $7,500 in medical expenses. Advertising, counseling, and living expenses for the birthparents vary widely from adoption to adoption. At the high end, these expenses can bring the total cost to above $30,000.
Benefits: You control the search process and the degree of openness with the birthparents, have direct contact with the birthparents, and aren’t restricted by agency requirements.
Risks: Costs are less predictable, as extensive advertising and medical expenses can drive up costs. Length of time to find a birthmother is unpredictable. As with an agency adoption, a birthparent can change her mind.

Adopting internationally

In 2007, Americans adopted more than 19,292 children from other countries, usually young children from orphanages in developing nations of Asia, Eastern Europe, and Latin America.

Most intercountry placements are handled by U.S.-based agencies, which often facilitate adoptions in multiple countries, each with its own requirements governing who may adopt and who may be adopted. The placing organization abroad may be a governmental body, private orphanage, foundation, or other social welfare organization. Most countries require one or both of the adoptive parents to travel to the foreign country.

The children may suffer undernourishment, developmental delays, or emotional problems, but be otherwise healthy. Adopters often consult a doctor with international adoption expertise to review a child’s records before accepting the referral, and to examine the child once home. A list of professionals organized by state is found at the American Academy of Pediatrics site, aap.org/sections/adoption. Adopting a child from another country may mean that the adoptive family will become a transracial or cross-cultural family, which presents special responsibilities for the parents.

Typical Cost: $20,000 to $35,000, depending on travel and other requirements of the foreign country.
Benefits: Wait and fees are typically predictable. Many adopters like not having to compete to be chosen by birthparents.
Risks: Paperwork to satisfy governments of domestic and sending countries can be cumbersome. Medical information can be erroneous or incomplete. Policy changes or domestic problems in the sending country can delay or suspend the process. Studies show that almost all children catch up developmentally, but there’s always a risk of long-term problems for any child who has spent time in an orphanage or other institution.

Adopting a waiting child

In 2005, more than 51,000 “waiting children” were adopted from the public foster care system in the United States. State agencies handle these adoptions, which typically happen in one of two ways: Families may apply directly to adopt a child in foster care, or first become foster parents and then adopt after the birthparents’ rights are terminated.

Waiting children adopted in 2005 averaged seven years old. Most were deemed to have “special needs” because of physical, mental, or behavioral disabilities, age, or membership in a minority or sibling group. Pictures of “waiting children” can be seen in books available at public libraries or online at AdoptUSKids (www.adoptuskids.org).

Typical Cost: $1,500 to $3,500 in initial expenses, but expenses can be recouped through a federal reimbursement plan or the adoption expense tax credit. Many families will receive a federal tax credit ($11,390 in 2007), regardless of their actual expenses.
Benefits: Reimbursements make cost negligible, and ongoing subsidies (averaging $350 per month) are available to help pay for the child’s needs, including medical and counseling, day care, and tutoring.
Risks: Older children may have emotional, physical, or mental disabilities, or other special needs. The process can take a while because state agencies often are understaffed.

Lois Gilman is the author of The Adoption Resource Book (Harper Perennial, 1998). Susan Freivalds, past executive director of Adoptive Families of America, is founder and editorial advisor of Adoptive Families magazine.

© 2008 Adoptive Families. All rights reserved. Reproduction in whole or in part is prohibited.