Original Article| Volume 36, ISSUE 1, P58-64, February 2023

Health Care and Adoption Service Experiences of People Who Placed Children for Adoption During Adolescence: A Qualitative Study

Published:August 17, 2022DOI:


      Study Objective

      To understand the perspectives of people who placed children for adoption during adolescence


      We conducted qualitative interviews with adults who placed children for adoption during adolescence. We recruited participants through social media and two adoption-related organizations. We audio-recorded and transcribed interviews. Using thematic analysis, 2 investigators coded the transcripts and identified themes.


      Telephone interviews


      Adults ages 18-35 years old who placed children for adoption before they were 20 years old


      Semi-structured telephone interviews

      Main Outcome Measures

      Qualitative data


      We conducted interviews with 18 individuals (median age of 32 years; range 21-35 years). The median age at pregnancy was 18 years (range 13-19 years). Seventeen participants identified as female and one as nonbinary. Themes included the following: (1) Negative experiences with counseling included limited empowerment to make choices about pregnancy or adoption options; (2) negative experiences with counseling included limited information about practical or financial support for pregnant adolescents; (3) negative experiences with the health care system included insensitivity or lack of awareness of the adoption plan at delivery; (4) positive experiences with counseling included comprehensive unbiased options counseling and adoption counseling emphasizing birth parent choice in openness and family placement; (5) positive experiences included longitudinal emotional support during pregnancy, particularly in ways that normalized adoption placement; and (6) participants desired therapy and/or psychological support following adoption placement.


      Individuals who chose adoption after adolescent pregnancy described positive and negative encounters with health care and adoption professionals that could serve as targets to improve the overall care experience for this population.

      Key Words

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      1. National Council for Adoption: 2017 adoption by the numbers. Available: Accessed January 16, 2022

        • Sisson G
        Estimating the annual domestic adoption rate and lifetime incidence of infant relinquishment in the United States.
        Contraception. 2022; 105: 14-18
      2. Evan B: Donaldson Adoption Institute: safeguarding the rights and well-being of birthparents in the adoption process. Available: Accessed January 19, 2022

        • Clutter LB
        Adult birth mothers who made open infant adoption placements after adolescent unplanned pregnancy.
        J Obstet Gynecol Neonatal Nurs. 2014; 43: 190-199
        • Clutter LB
        Open adoption placement by birth mothers in their twenties.
        MCN Am J Matern Child Nurs. 2017; 42: 345-351
      3. Clutter LB: Perceptions of birth fathers about their open adoption.
        MCN Am J Matern Child Nurs. 2020; 45: 26-32
        • Sisson G
        • Ralph L
        • Gould H
        • et al.
        Adoption decision making among women seeking abortion.
        Womens Health Issues. 2017; 27: 136-144
        • Sisson G
        Choosing life’: birth mothers on abortion and reproductive choice.
        Womens Health Issues. 2015; 25: 349-354
      4. Pact. Available: Accessed February 5, 2022

      5. Bravelove. Available: Accessed February 5, 2022

        • Braun V
        • Clarke V
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Barroso R
        • Barbosa-Ducharne M
        Adoption-related feelings, loss and curiosity about origins in adopted adolescents.
        Clin Child Psychol Psychiatry. 2019; 24: 876-891
        • Walkner AJ
        • Rueter MA
        Adoption status and family relationships during the transition to young adulthood.
        J Fam Psychol. 2014; 28: 877-886
        • Farr RH
        • Flood ME
        • Grotevant HD
        The role of siblings in adoption outcomes and experiences from adolescence to emerging adulthood.
        J Fam Psychol. 2016; 30: 386-396
        • Collishaw S
        • Maughan B
        • Pickles A
        Infant adoption: psychosocial outcomes in adulthood.
        Soc Psychiatry Psychiatr Epdemiol. 1998; 33: 57-65
        • Reppold CT
        • Hutz CD
        Effects of the history of adoption in the emotional adjustment of adopted adolescents.
        Span J Psychol. 2009; 12: 454-461
        • Ugwu C
        • Nugent C
        Adoption-related behaviors among women aged 18-44 in the United States: 2011-2015.
        NCHS Data Brief. 2018; 315: 1
        • Tan TZ
        • Kim ES
        • Baggerly J
        • et al.
        Beyond adoption status: post-adoptive parental involvement and children's reading and math performance from kindergarten to first grade.
        Am J Orthopsychiatry. 2017; 7: 337-346
        • Koh BD
        • Rueter MA
        Contributions of parent-adolescent negative emotionality, adolescent conflict, and adoption status to adolescent externalizing behaviors.
        J Clin Child Adolesc Psychol. 2011; 40: 825-836
        • Siegel DH
        Open adoption: adoptive parents’ reactions two decades later.
        Soc Work. 2013; 58: 42-52
        • Berge JM
        • Mendenhall TJ
        • Wrobel GM
        • et al.
        Adolescents’ feelings about openness in adoption: implications for adoption agencies.
        Child Welfare. 2006; 85: 1011-1039
        • Wrobel GM
        • Ayers-Lopez S
        • Grotevant HD
        • et al.
        Openness in adoption and the level of child participation.
        Child Dev. 1996; 67: 2358-2374
        • Grotevant HD
        • McRoy RG
        • Elde CL
        • et al.
        Adoptive family system dynamics: variations by level of openness in the adoption.
        Fam Process. 1994; 33: 125-146
        • Custer M
        Adoption as an option for unmarried pregnant teens.
        Adolescence. 1993; 38: 891-902
      6. SisterSong Collective: Reproductive justice. Available: Accessed January 22, 2022

        • Bryson A
        • Koyama A
        • Hassan A
        Addressing long-acting reversible contraception access, bias, and coercion: supporting adolescent and young adult reproductive autonomy.
        Curr Opin Pediatr. 2021; 33: 345-353
        • Ross L
        • Solinger R
        Reproductive Justice: An Introduction.
        University of California Press, Oakland, California2017