Post-adoption Contact and Relationships with Birth Family Members

The chapter draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort), completed on average 18 years after placement, and interviews focusing on 24 adult adoptees. Face-to-face post-adoption contact was a legal requirement. After placement with adoptive families, 93% of adoptees had contact with birth family members; at follow-up, 56% still saw at least one member of their birth family; 69% of both adoptees and adoptive parents thought contact was ultimately beneficial. There was minimal evidence of contact with birth parents destabilising placements. However, it introduced a ‘painful transparency’ for all parties and could be problematic. Over time, contact supported children’s identity needs by incorporating knowledge of their antecedents and could mitigate their difficulties with attachment, separation and loss. It forced all parties to engage with one another and helped adoptees achieve closure.

The Children

The children’s early experiences provide a context for assessing subsequent outcomes. Data collected from case files and records presented to the courts show that before separation from birth parents, almost all 210 adoptees had experienced serious and often multiple forms of maltreatment; this was the primary reason for removal. Before entering their adoptive homes, 69% of the adoptees had had four or more adverse childhood experiences (ACEs), 32% had experienced failed reunifications and 48% had had three or more foster placements. Adverse childhood experiences before entry to care, harmful experiences in care and repeated exposure to grief and loss are likely to have contributed to the high prevalence of emotional and behavioural difficulties, displayed by 49% of the adoptees. According to our classification, 57% were at high risk of experiencing adverse outcomes in adulthood.

The Adoptive Parents

The chapter draws on case file data and papers presented to the court at the time of the adoption order. The 210 adoptees were placed in 138 adoptive homes. The adoptive parents were on average ten years older than birth parents and had more stable relationships. They were also better educated. Most lived in owner-occupied homes and the secondary carer was generally in full-time work. Attempts to match children with families of the same ethnicity and culture and to place siblings together were mostly successful: 77% of children with siblings were placed in intact groups; only 8% were placed alone. Almost half (44%) the parents adopted more than one child; 9% adopted three or more; many also had biological children still living with them. While adoptive parents had considerable resources, they also faced challenges including helping children overcome the sequelae of early adverse experiences and parenting several children with diverse needs.

Conclusion: Implications for Policy and Practice

The book focuses on a study of 210 children in out-of-home care in Australia who were adopted over a 30-year period; 93 were traced for an average of 18 years after placement. The requirement for regular face-to-face contact with birth parents was considered beneficial by 69% of participants. Other findings show the adoptees’ extreme vulnerability, improved stability post adoption and the importance of adoptive parents’ commitment in facilitating positive outcomes. They also imply that child protection policy should focus on strengthening family support and more timely decision-making when parents cannot overcome their difficulties. Policy for children in long-term foster care should focus on reducing instability, increasing the quality of care and providing better care leaving support. Internationally, adoption policy needs to reflect the increased similarities between adoption and fostering engendered by open adoption from care, and acknowledge their implications for recruitment, training, contact arrangements and post-adoption support.

Issues Facing the Birth Parents and Their Implications for Open Adoption

The 210 children in the full cohort came from 142 families. Their birth parents’ circumstances provide a context for evaluating adoption outcomes. The chapter explores data collected from the children’s case files and records presented to the court at the time the order was made. Parents demonstrated a high incidence of factors known to be associated with recurrent child abuse: 31% of mothers had experienced abuse in their own childhoods; 45% were known to statutory child welfare services before their child’s birth, and 29% had already experienced the permanent removal of a child. Almost all parents struggled with complex factors including mental health problems, substance misuse, unstable relationships and domestic abuse that placed their children at risk of harm; for some parents, cognitive impairment was an exacerbating factor. About 10% of birth parents had died, and 23% of mothers and 60% of fathers had already lost contact with children before the adoption placement.

The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis

Background Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. Method Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. Results Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies ( n = 4871) was 26.0% (95% CI 20.0–32.0%) for mothers, and estimate based on three studies ( n = 2606) was 13.0% (95% CI 7.0%–18.0%) for fathers and 23.0% (95% CI 17.0–29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents’ PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. Conclusion There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.