Infertility - Care of the adoptive mother

1. The adoptive mother may come to the decision to
adopt through many ways, including primary
choice or failure of fertility programs. She may be
burdened with feelings of failure and grief at the
inability to have a child from her body, or may
choose adoption as a start or addition to her family.
2. The adoptive mother goes through several stages
of emotional lability. She and her husband must
decide to adopt, deal with the stress, lack of
control and insecurity of the adoption process,
and deal with the medical, social, and
psychological issues of incorporating an adoptive
child into the family. Adoption may be a first or
last step, and the woman may have powerful
feeling for and against adoption and urgency to
have a child.

3. The physician may counsel the woman about
adoptions, counsel about particular disease or
children with handicaps, and treat the child once
it is adopted. The physician may need to help the
family integrate the child into the family and help
to give advice about dealing with the stresses of
adoption.
4. The decision to adopt entails many steps.
a. Factors such as infertility, failure to produce
genetic children, need for children with the same
genetic make-up, desire to help needy or
handicapped children, and grief and anger about
failure of her own body are all complex parts of
the decision. As well, the difficulty of single
parenting, gay parenting, and blended families
may be part of the decision. The physician may
counsel the family during this process.
b. The adopting parents must decide if and how
they can deal with a special needs or
handicapped child or a child from another
ethnic background.
c. Women who feel that they have lost control by
inability to have children may jump joyfully
into the obsessive paperwork and details
needed to adopt a child. It may give them a
feeling of control.
d. Preadoption counseling may be as important
as preconceptual counseling. The physician
should inquire into the mother’s daycare and
leave options, her insurance status and
back-up. Have the adoptive parents discussed
their plans with their family? Adopting older
children may entail special arrangements for
daycare or schooling.
5. Preadoption parent physical examination
a. The physician is often asked to perform the
preadoption physical. There are some
conditions that may make an adult hesitate to
adopt (Table 8.3).
b. Any condition that causes an individual to
need caregiving themselves or give it to family
member, or any progressive or terminal
disease, should cause hesitation about ability
to adopt a child.
c. However, it is not the duty of the physician to
judge who can adopt, but just counsel and
document. The judge, county, country, state or
adoption agency will have its own
requirements. Some countries have their own
requirements. In one case, a judge may decide
that grandparents or aunts over age 50 with
some chronic condition would be better
adoptive parents than strangers.
6. The wait
There is an intensely painful period between the
decision to adopt and the arrival of the child.
Anticipation, worry, anxiety, legal, and social
problems are all factors in this time. Because the
womanmay be suffering this wait and does not want
to tell or burden friends and family, the physician
may need to be available for support and ventilation.

Posted in: Health,Infertility