By Alison Lewis, MSW, LICSW, MTS
I am the mother of no one at all and truthfully, I do not know what it is like to stand on either side of the adoption equation. But I can also say that for as long as I can remember, I have long believed that adoption can be a profound act of love, by both parties. In my role as a clinical social worker supporting families in the NICU, Labor & Delivery, maternity units, and non-Transplant Pediatric patients. I have worked with parents who are considering adoption for their baby and exploring their pregnancy options during difficult and emotional moments.
Recently, I had the opportunity and pleasure of working with an adoption counselor at The Barker Adoption Foundation, a licensed adoption agency serving Maryland, Washington, D.C., and Virginia. For decades, Barker has supported birth parents and adoptive families through every stage of the adoption journey. If I had to choose one word to describe our work together, it would be ‘collaboration.’ From start to finish, we shared a common goal, which was to support the birth family in whatever way they needed. Whether they chose to parent or decided that placing their baby for adoption was the best path for their child to thrive, we maintained communication throughout the process, until the baby was discharged from the NICU…a necessary step towards the fulfillment of the birth parents’ ultimate goal of their baby’s adoption placement. Our collaborative effort ensured that both organizations obtained the necessary information and documentation, in a timely manner. For Barker, that included medical details and progress updates. For the hospital, that included an understanding of who the baby would be discharged to, ensuring that those individuals would be appropriately prepared to take care of the baby’s needs after discharge, completion of the hospital’s adoption policy paperwork and logistical issues such as health insurance coverage. At the center of the process was the baby and birth family, and their hopes and hearts.
Parents who come to the hospital are navigating an unplanned pregnancy and wondering what their options are. Some may already be working with an adoption agency to create an adoption plan, while others are learning about adoption for the first time. In these moments, the most important thing is that parents receive accurate information, compassionate support, and the space to consider what decision is right for them and their baby.
For a healthy term infant, while the heart aspect and the paperwork aspect remain part of the story, there are elements that come along with having an infant in the NICU, which add another and very likely, unexpected element to the adoption experience. Depending on the reason for the baby’s admission to the NICU, this chapter may be not only longer than anticipated but it may also introduce complex considerations if the baby is diagnosed with significant or even lifelong medical issues. It is important that the prospective parents continue to feel equipped to meet the baby’s needs and ensure their suitability to do so. That spirit of collaboration which began the journey, will become even more important. As the NICU social worker, part of my role is not only to help to coordinate communication between the adoption counselor and the medical team, but also to support the birth family and the prospective adoptive family (if they have been identified), in the same way that I would in any other family circumstance.
While adoption is not a frequent occurrence here at the hospital, I have worked with a few families over the years. Usually, the birth family has a plan prior to delivery, and I am given a heads-up by the agency. Sometimes, the birth family has requested assistance with identifying an agency. But there have also been occasions when adoption was the starting point, but after the baby was born and perhaps, following further conversation with other family members, the birth parent(s) have a change of mind and heart, and decide to parent the baby themselves. These shifting dynamics remind us of the complex and nuanced layers of the lives of families and there may be times when our professional objectivity is challenged by what looks like ‘not the best decision’ for either the baby or the birth family.
Personal, familial, cultural, and/or religious beliefs and norms can impact the decision to pursue or not pursue an adoption plan. Perhaps as the birth parent, you don’t want to disappoint others; you worry about how you will manage if you do decide to parent the baby; you fear that family support may only realistically be present in the moment, but what about in a month’s time or for the long haul? Many thoughts may arise as you seek to make the best decision that you can in the face of two difficult choices, both with forever consequences.
There are some life decisions that cause us to question, to doubt…that stir up a mix of emotions. Parents considering adoption often carry many emotions—love, fear, uncertainty, and hope. Access to confidential, non-judgemental, compassionate support for birth parents during this time is essential. Social workers, adoption counselors, and medical teams all play an important role in helping families understand their choices and move forward with confidence. Adoption is a core moment in life which carries such a heavy, thoughtful decision making and that is as it should be, because it matters so much. We can know in our head, and even in our heart, that this (parenting or placing) is the right thing to do, the best thing, and yet…
So how can I best support parents who are considering an adoption plan? As the saying goes, there is a reason that we have two ears but only one mouth! It is a reminder to listen more, to speak less, and to give advice when asked and even then, do so carefully. Allowing for ambivalence to show up and make its presence known. Leaving room for parents to change their minds and perhaps to change them back again. It is also important for me to recognize and to acknowledge the role of the adoption counselor as a primary team member and to trust that they will continue to work with the parties involved and address their ongoing needs. I can balance staying in my lane while at the same time utilizing my professional skills and strengths authentically, to support the family.
The longings of our heart are sometimes answered in unexpected ways and sometimes at imperfect moments. But love makes room for that. As I reflect on the recent collaboration with Barker, I shared with the adoption counselor that I had said a prayer that the prospective adoptive family would not let uncertainty, and fear of what the future might hold, stop them from following their heart’s desire if they truly believed that this was the baby for them. At the beginning of the story, it may not appear as though the pieces will come together or perhaps what initially seemed like a sure thing does not pan out. But just like very big puzzles can eventually be put together, so too can parenting plans, even complicated ones, when the right pieces find their way to each other, with support and perseverance and good collaboration.
About the author:
Alison Lewis, MSW, LICSW, MTSA is a clinical social worker at MedStar Georgetown University Hospital for the NICU, Labor & Delivery, maternity units and non-Transplant Pediatric patients.