There are numerous reasons why parents choose International adoption, but each case usually has a unique story attached to it. Some people have an affinity for a certain culture, some for humanitarian reasons, and some because they believe the risks are less than those for domestic adoption. Whatever the reason, any family considering international adoption must be well informed and accepting of the risks and realities of adopting internationally.
Lack of Information:
The information that is received on any child is typically minimal. The referral information will most likely include little to nothing about the birthmother. The child may have a genetic predisposition for medical or psychiatric illness which will not be known as family histories are not provided. A history of alcohol/drug abuse is not often known. Whether or not pre-natal care was obtained is typically unknown. Complete orphanage records are not sent. Sometimes diagnosis are made and test are performed that do not make any type of medical sense. When parents are lucky, a medical report may be available providing information as growth parameters, past medial history of what occurred in the orphanage and many times a video and pictures. While all children from International adoption are considered to be at minimal risk, this information when taken to a Pediatrician can help to uncover other more significant problems that are not visualized by the referral source.
The countries where children are primarily adopted from usually have inferior medical technology and limited diagnostic capabilities. Although most of the children have some form of medical care, the standards of medical care for the children may not be the same as that for the general population.
Until recently, many infectious diseases were relatively rarely seen in the the United States, but they are a way of life in many countries. Children may be tested for certain diseases and be negative at the time the test was taken. However, that does not ensure the test was accurate or that the child has not subsequently become exposed to the disease. Viruses and infections can sweep through an orphanage. Children who have had frequent colds and ear-infections (not always known) may have built an immunity to some medications and some may have some hearing loss.
Orphanages do not provide children with well-balanced diets so the children tend to be small in stature and underweight which can have immediate and/or long-term medical implications.
The lack of well-balanced diets can lead to vitamin deficiencies or other associated conditions. Due to the lack of physical and intellectual stimulation, the children are generally developmentally delayed with poor muscle tone which may or may not mask a medical or neurological condition.
Uncontrolled water-air-soil pollutants, lead paint and industrial use of lead are some of the environmental hazards faced in some countries. Alcohol abuse and cigarette-smoking are socially acceptable behaviors in many countries, even during pregnancy.
Children With Special Needs:
The definition of "special needs" has come to mean children with physical disabilities or medical conditions, however, it is often not so simple.
The lack of a medical and social history, available medical care, living conditions, environmental conditions, disease, and incomplete and/or inaccurate referral information leave so many unknowns that we can not say any child is healthy.
Although International Physicians may be capable at diagnosing visible medical conditions, there is little to no awareness of psychological problems. The emotional and physical impact of the living conditions may lead to long-term difficulties. The younger the child, the more unknowns there are as the child has not reached many of the physical and developmental levels necessary for more complete assessments.
Many children are described as "healthy" by the referral sources or foreign government, but this needs to be taken in the context of the above conditions and the unknowns should be considered carefully.
Other Risks and Realities of IA:
No-one can predict the future of any adoption program in any particular country. Referrals of children should be considered tentative until the adoption has been finalized and the child is home. Countries may unexpectedly close, laws and requirements may suddenly change causing delays or moratrarium on all adoptions. (like what occurred in Romania). Other reasons, such as birthparents changing their minds, referrals lost to in-country adoption, or children may become seriously ill, could result in the child no longer being available for adoption.
If all of the risks of IA were to become realities, no-one would choose to adopt internationally; however, many times the risks do not always become realities and there are many families who have adopted healthy, happy, flourishing children who are thriving under the loving care of their new parents.