Friday, July 27, 2018

INFERTILITY STRESS SYNDROME: PTSD IN ADOPTIVE PARENTS



During the 1980’s, Dr. Millard was active in many adoption reform/education groups. Aware that infertile pre-and-post-adoptive parents were in need of education and therapy regarding their loss and trauma issues, she joined and served on the board of directors of the San Francisco Chapter of Resolve: The National Infertility Organization, and regularly presented workshops at San Francisco Resolve’s two annual Symposia, focusing on Infertility (medical and psychological trauma) and Adoption (choosing well-informed professionals and coping with psychological challenges).

The focus of Maryl’s workshops: (a) Making the transition from infertility treatment to adoption, and (b) Post traumatic stress disorder in infertility and adoption, (c) Open vs. Closed Adoption, (d) Common Fears in Adoption, (e) Relationships with birth parents, (f) Raising adopted children in open adoptions, (f) Why Adoptive Parents Fear Birthparents.

Maryl’s Ph.D. dissertation was a statistical analysis of Post- Traumatic Stress Disorder in infertile pre-and post-adoptive parents who were traumatized by the experience of infertility, and often traumatized further by the stress of the adoption process.

The research confirmed significant stress from miscarriages, stillbirth, long-term hormone treatments, life-threatening ectopic pregnancies, invasive surgical treatments, in-vitro fertilization procedures, marital conflict, and lack of social support.

Couples reported a sensense of isolation, an absence of social support from family, friends, coworkers, and employers, as well as massive financial debt for under-insured medical procedures, and lost time at work. The couples in this study were heterosexuals and had statistically significant gender differences in stress-related behavior (which added more alienation and stress to their relationship).

Last but not least, as walking wounded, the couples in this study experienced significant stress navigating the adoption system, which still supports adoption agency “professionals” who facilitate adoptions “in house” without providing qualified, fully separate adoption counseling for all parties. This group of agency adoption practitioners suffers at one end of the spectrum from a lack of transparency, and at the more independent or private adoption end, the industry has a significant number of private adoption attorneys and facilitators, many of whom lack training and transparency, and undervalue counseling for their clients during and after the process. (There are some agencies, private adoption attorneys and facilitators, who only participate in open adoptions with counseling and mediation, assisting the parties to clarify their goals and create an open adoption agreement). Still, problems remain in the way many adoptions are created.

Before open adoption was established as a healthier alternative to secret adoptions, the highly-stressed population of infertile couples (and some single adopters) feared contact with birthparents, and they initially opposed open adoption. Adoptive parents paid for the professional services, which influenced professional policy makers to favor their preferences over those of the birth/first parents. Many adopters still choose closed agency or private adoptions, and some choose international adoptions or closed foster adoptions in an attempt to avoid contact with birth parents.

A combination of PTSD diagnosis and treatment, plus supportive counseling and mediation for adoptive and birth/first parents during the adoption process, creates a context that mitigates fear and shame.

By the 1980’s, open adoption became the professionally preferred model of adoption by many clinical social workers and psychotherapists in the United States. For a copy of the Infertility Stress Syndrome research, and an overview of how these couples navigated through infertility treatment and open adoption, see Infertility Stress Syndrome, A Study of Pre-and Post-Adoptive Parents, by Maryl Millard, Ph.D. Copies are available on Amazon and Kindle.

In many legal jurisdictions, open adoption is the only way that adoptive parents can obtain a copy of their child’s original birth certificate and birth parents’ contact information. Likewise, for birth parents, open adoption provides a way for them to consider many prospective adoptive parents, and personally choose who will adopt their child. Open adoption also provides birthparents with the accurate identification, background and contact information on the adoptive parents. Based on what we know about the psychological damage wrought by closed adoptions, it is surprising that they remain legal. Isn’t it time adoption policies and laws reflected some respect for the needs of adoptees and birth/first parents, even if they aren’t the clients who pay the salaries and operating expenses of agencies and law practices?

Open adoption contracts are informal agreements regarding contact between the birth parents, the adoptive parents, and the child, both before and after the legally binding adoption is filed with the court. Regardless of how they are crafted, they are not a formal, legally binding part of adoption law; they are ‘good faith’ contracts, the success of which depends on the dynamics that evolve between the parties after the adoption. As with any relationship between relatives bound by blood or legal agreement, there are vicissitudes of compatibility throughout the family members’ developmental stages.

There is no factual support for the fear-based myth that birthparents will interfere with the adoptive family, or in any way harm or alienate the child from the adoptive parents. Isolated cases may result in adversarial relationships but are not numerous enough to create any significant predictive probability of emotional harm. Most importantly, open adoption provides a starting point for an extended family relationship, which will likely fluctuate, depending on each person’s values, geographic location, and psycho-social dynamics. The open adoption relationship is largely controlled by adoptive parents, so until the adoptee is an adult, there will not be an opportunity for a relationship in which each participant is unrestricted regarding contact. If the adoptive parents never worked through their insecurities, they are likely to create barriers to the valid needs of adoptees and birth/first parents.

In adoptions that involve parents whose children were removed due to abuse or neglect, how open the adoption is depends on responsible safety assessments, especially when birthparents are incarcerated for violent crimes, or drug-addicted. In many cases, foster children who are adopted often have relatives who can offer support and family of origin information while the child matures within the adoptive family.

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