March 2017 Ask the Expert: Adoption

March 1, 2017

Breast cancer and its treatments can make pregnancy difficult or impossible. But there are many kinds of families, and many ways to build a family. Adoption is one of those ways.

In March, Living Beyond Breast Cancer expert Gwendolyn P. Quinn, PhD answered your questions about adoption, including how to decide if adoption is right for you, how the process works, and how a history of breast cancer could affect your adoption experience.

 

Remember: we cannot provide diagnoses, medical consultations or specific treatment recommendations. This service is designed for educational and informational purposes only. The information is general in nature. For specific healthcare questions or concerns, consult your healthcare provider because treatment varies with individual circumstances. The content is not intended in any way to substitute for professional counseling or medical advice.

Are there any resources you recommend for women who have had cancer and are considering adopting?

There are several books you may want to read, including Gina Shaw's Having Children After Cancer:How to Make Informed Choices Before and After Treatment and Build the Family of Your Dreams and Anne Van Donkersgoed's Year of the Babies!: A Journey Through Loss, Childlessness, Adoption and Cancer. You may also find personal stories, such as Adopting a Child After Cancer, helpful.

Also, the Oncofertility Consortium at Northwestern University lists a variety of cancer-friendly adoption agencies.

How common is it for women who have had cancer to adopt?

Adoption in general is not common. Data are not collected (to my knowledge) on the number of cancer survivors who adopt children. In general, 2.5 percent of the population is adopted and 87 percent of all adoptions are domestic (meaning the children are born in the US).

What different ways are there to adopt children, and are certain ones easier for people who have had cancer?

There are a variety of types of adoption, including public and private agencies (nonprofits), which are state regulated; and independent agencies (for-profit), which may include a private arrangement through an attorney and the birth mother/father and the adoptive family.

The adoption process may be open: This means the birth mother/father select the adoptive family and decide the amount of future contact desired. Or it may be closed: This means neither the birth parents nor the adoptive parents have access to one another's names or contact info. 

Using an agency that is friendly toward cancer survivors is one way to make the process easier. 

Can adoption agencies decide not to let me adopt a child because I’ve had cancer?

Yes, an agency can deem a potential adoptive parent unsuitable for a variety of reasons, including health. It's also possible that a birth mother (in the case of a private, open adoption) may choose not to select a cancer survivor. Although we do not know the number of agencies who may have excluded a parent due to a prior cancer history, there are several anecdotal stories of birth mothers intentionally choosing a cancer survivor with the idea that such a parent has a greater appreciation for how valuable life is.

How expensive is adoption?

Costs vary considerably. Domestic (within the US) adoption ranges from $12,000 to $22,000 and international adoptions range from $19,000 to $30,000. This website provides information on resources that may assist with costs.

How do people decide if adoption will be right for them?

Deciding whether or not to adopt is a very personal decision. There are popular discussion forums, such as the Cancer Survivors Network, provided by the American Cancer Society, that have specific discussion boards for adoption and cancer that  people may find helpful. This provides an opportunity to discuss adoption and the process with people who have been through a similar experience. There are several blogs that may be helpful to read about the adoption experience, including this one.

Several agencies and adoptive parents suggest considering the following 10 questions:

1. Why do you want to adopt – because you want to be a parent, or for some other reason?

2. Can you handle the financial commitment of parenthood? Healthy children cost about $200,000 to raise between ages 0-17. (This figure does not include college.)

3. Can you handle not being biologically related to your child?

4. What kind of adoption would you want: domestic, international, open, semi-open, or closed?

5. What age child would you want? Newborns are the most sought after and have the longest waiting list.

6. Would you accept a child of any race of culture? One with special needs?

7. How and what will you tell your friends and family about the decisions to adopt? Will you share that your medical history was part of your reason for adopting? Will they accept a child of a different race or ethnicity than your own?

8. How and when will you tell your child about his or her adoption?

9. How will you feel if a child you adopted wants to learn more about his or her background or birth parents?

10. What support network do you have in place? This is important not only for the adoption process, but also for parenting a child.

These questions were adapted from HowStuffWorks.

How involved is the process of an adoption agency evaluating a family and deciding if they’re fit to be adoptive parents? How long does it take?

Adoptive parent evaluation is a very involved process, which varies by state and agency. However, the laws of every state require all prospective adoptive parents (no matter how they intend to adopt) to participate in a home study, which includes several interviews, trainings and home visits, conducted by a licensed social worker or caseworker. This can take several months and up to a year to complete, depending on the individual state and adoption agency.

Do I have to disclose my health history to an adoption agency?

Yes, it is required that all adoptive parent applicants provide a health history. While this may make the adoption process challenging, there are some agencies that have expressed their willingness to work with patients with a cancer history. The Onocofertility Consortium has created a list of these agencies.

When adopting, can you specify that you want a child of a certain sex or age, and whether you want a child with special needs or not?

Yes, you have the right to specify what characteristics are most desirable for you. This is something you should communicate to the adoption agency. 

Is it entirely up to the biological parents whether they will be part of the adopted child’s life, or do the adoptive parents have a say in that too?

When the biological parent decides to place the child up for adoption, it is their decision whether or not they would like to be involved in the child’s life in the future. A closed adoption means that there is no contact whatsoever between the birth parents and the adoptive parents and child after the adoption takes place. Open adoptions allow for biological parents to remain in the child’s life in some capacity, which depends on the terms of a postadoption contract. Postadoption contact agreements, also known as cooperative adoption or open adoption agreements, are arrangements that allow contact between a child's adoptive family and members of the child's birth family after the child's adoption has been finalized.