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Effects of adoption on birth mother
The decision to give up the birth rights of a child is a heavy burden on the psychological makeup of the birth mother. Birth mothers can feel a sense of loss for someone who is still alive. She may mourn the loss of her mothering role and for who her child may have become as her son or daughter. These feelings may resurface in later years, perhaps on the child’s birthday, or other important milestones in the child’s life. Some doctors report that birth mothers may feel grief when they have more children because it may frequently evoke the memory of the child they gave up. If they are faced with future infertility, they may believe it is a form of “punishment” for relinquishing their parenting rights over the child. Many birth mothers continue to mourn the loss of their child, but with varying intensity.

Stages of grief
It is not until the mother actually gives up her child for adoption that she experiences, what Julie Axelrod believes is similar to the five stages of grief: denial, anger, bargaining, depression, and acceptance. Inspired by Elisabeth Kübler-Ross’s On Death and Dying, the author attempts to show how those who have experienced the death of a loved one may be psychologically similar to a birth mother giving up her child for adoption. The following occurs in each stage:

Denial
The overwhelming nature of the mother’s emotions allow her to feel numb to the situation. Essentially reality has not set in.

Anger
This emotion is a manifestation of reality, the understanding of how devastating an impact her decision has made on her and her understandable vulnerability. This may cause her to lash out to those closest to her or on herself.

Bargaining
The mother begins to rethink the decision she has made. She feels the need to regain control of her emotional state by attempting to bargain with a religious or psychological figure to rid her of her sense of guilt.

Depression (2 Types)

 * In the case of a death, the mother would begin to worry about the costs of the funeral and burial, but birth mothers would relate those costs to how expensive it is to care for a child.
 * This is a more secretive emotional state, where the mother feels alone. She feels that she is the only one who knows what she is going through, and feels it is best to vent and reflect by herself.

Acceptance
There is no real timetable as to when or if a mother will ever be able to accept her decision, but at this stage she begins to feel at peace with her decision. She still struggles with the reality of the adoption, but understands and truly believes that she was acting in the best interest of the child.

Identity issues
Placing a child for adoption may also prompt identity issues in birth mothers. They may feel a desire to establish who the child will be in their lives and what role he/she will play in their life. Birth mothers in open or mediated (i.e., semi- open) adoptions may be presented with more identity issues as they interact with the adoptive family. Placing a child for adoption does not mean a birth mother will never be able to contact the child. Adoption can include some communication between the birth mother and adoptive family. Both parties need to decide the level of openness for the adoption.

Forming relationships post adoption
Some birth mothers may have difficulty forming and maintaining relationships post an adoption. This could be because of persisting feelings of loss and guilt, or due to the fear of becoming pregnant again and repeating the process. Some birth mothers may try to replace the loss quickly by beginning a new relationship, or giving birth again—without dealing with the grief of the adoption. For some birth mothers, the capacity to establish a successful long-term relationship may be conditional on the openness with which they can relate their past experiences of the adoption to their partner. Moving on or the eventual acceptance of this loss does not mean that a birth mother has forgotten the child, but instead means that she has integrated the loss into her life.

Exploitation of birth mothers
In undeveloped nations, international adoption is commonly treated as a business where women and children are commodities. This violates several standards and guidelines given by the United Nations. In many cases, reports from Argentina, Brazil, El Salvador, Guatemala, Honduras, Thailand, and other nations indicate that children have been placed for adoption after being purchased, indentured, or abducted from the birth mother. In one instance in Colombia, children were bought for $600 and sold for $10,000 with the use of illegal and falsified papers. In Honduras, it was found that to remedy inadequate prenatal care, many merchants pay teenage girls to get pregnant and monitor them to make sure they eat well and receive some kind of care. After the baby is born, $50 is paid to the birth mother in exchange for the healthy baby. While foreign adoptions provide several countries with much needed foreign currency, the exploitation of birth mothers raises several ethical and human rights issues. The lack of information on the circumstances involving the conception, birth, and the placement of a child poses a dilemma for women adopting internationally who have prochoice views and yet quite possibly adopt from women who have little to no choice.