exposing the dark side of adoption
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The Adoption Maze

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The supply of babies is severely limited, and the market is unregulated. But savvy couples manage to succeed despite high costs, bureaucratic roadblocks, and outright scams

By Kim Clark and Nancy Shute

Posted 3/4/01

NOVOSIBIRSK, RUSSIA--What longing is strong enough to pull a person halfway around the globe for a rendezvous with a stranger? It drew Barbara and Randy Combs from their home in Frederick, Md., to a Siberian winter 12 time zones away. On February 21, they stood in Novosibirsk's Baby Home No. 2, looking for the first time at 9-month-old Viktoria Istomina, who stared solemnly back. The moment was oddly quiet, considering that it would change all their lives forever. "In the photos she had brown eyes," Barbara said, "but they're beautiful blue, blue-gray." Randy petted the child's back. "Look at that!" he said. "When you smiled, it pretty much made my day."

The Combses are among the tens of thousands of Americans who decide each year to adopt a child. Barbara, a 41-year-old accountant, and Randy, a 42-year-old computer systems engineer, had anticipated producing a sibling for their 3-year-old daughter, Jordyn. But a ruptured ectopic pregnancy that almost killed Barbara last February made that impossible. "I wasn't sure about adoption," Barbara says, "but Randy had no qualms whatsoever." By summer's end, Barbara had laid to rest her fear that she would favor her biological child over an adopted one. They knew right away they were going to Russia; friends had just adopted from there, Barbara's family had Russian roots, and she was convinced that no American birth mother would ever pick them, because they were over 40 and already had a child. "There are children out there," Barbara said. "Let's do it."

In the past 35 years, adoption has been transformed from a shameful family secret to a praiseworthy act--one that finds families for children, helps birthparents in desperate straits, and brings the blessing of parenthood to the childless. Because of rising infertility rates and increasing societal acceptance of gay and single parents, interest in adoption has skyrocketed. A survey of American women in 1988 found just 200,000 considering adoption. By 1995, the last year for which statistics are available, 500,000 wanted to adopt a child. But most want a healthy white infant, and the supply of those has plummeted. As a result, the number of Americans heading overseas to build their families has more than doubled in the past decade to more than 18,000 a year.

But just as society has become more accepting of adoption, the process has become more difficult, expensive, and potentially heartbreaking. Adoption has moved from the tightly self-regulated realm of social-service agencies and unwed mothers' homes to the free market. Babies are hawked on Web sites that trumpet "FEES REDUCED" for individuals such as Child No. 678, "deformed right hand but mentally fine and very sweet." Hundreds of for-profit businesses and unlicensed facilitators promise to connect prospective parents with the child of their dreams--with costs ranging from $15,000 to $50,000. "I used to say adoption has become a business," says Susan Soon-keum Cox, a vice president with Holt International Children's Services in Eugene, Ore. "Now I say it's become an industry."

The infamous Internet twins case showed just how cutthroat the wild frontier of adoption can be. California facilitator Tina Johnson allegedly took $6,000 for placing the twins with a California couple, then turned the children over to a British couple for $12,000. The Britons whisked the children from California to Arkansas to take advantage of discrepancies in state laws and hurried them out of the country. The children are now in foster care in England while authorities sort out the sordid mess. And in thousands of less notorious cases, families struggle with a system that seems broken and ask: If adoption is so good, why does it have to be so hard?

Parents who want to adopt must make a dizzying array of choices--Which agency is reliable? Should they risk working with an unlicensed facilitator? Should they accept a child who may not be as healthy as claimed?--with little objective information to help them. And these families are increasingly likely to have their hearts broken and their bank accounts drained by a failed or fraudulent adoption. It was bad enough in 1990 when, insurance statistics show, fully 20 percent of families trying to adopt lost money to a birthparent's change of mind or a con artist. But by 1999 a heartbreaking 28 percent of insured adoptions failed.

Unprotected. To add insult to injury, adopting parents have surprisingly few rights. Scandals in the 19th and 20th centuries led to strong laws protecting children and birthparents, but there is virtually no protection for those wanting to adopt. State regulators across the country say they ignore most of the complaints against agencies because there are no rules requiring explanation of fees or accurate information about waiting lists, let alone refunds for a failed adoption.

It was perhaps inevitable that adoption would become more expensive and riskier. That tends to happen in any endeavor where there's an imbalance between supply and demand. In fact, when the supply of children exceeded demand in the mid-19th century, urban street children became a commodity; they were rounded up and sent west on "orphan trains," which would stop in farm towns where labor-hungry farmers would take their pick. Though some of the 84,000 orphan-train riders may have ended up in loving homes, many were abused.

But by 1950, demand for children started to outstrip the domestic supply, and in recent years the imbalance has become extreme. In 1988 there were 3.3 families looking for every adoption that was finalized. By 1995, there were 6, according to the National Survey of Family Growth. Of course, there has never been any shortage of adoptable children in the nation's foster care system (118,000 at last count). But red tape makes it difficult to pry those children loose. In addition, surveys consistently show that most adoptive families want healthy infants. Two thirds of foster care kids are at least 5 years old, and many have physical or emotional handicaps.

Race also plays a role. Although black and white women are equally likely to try to adopt, there are more white people in the population--and more black and mixed-race children in need of families. Of the adoptable children in foster care, 61 percent are black or Hispanic, and 32 percent are white. At the same time, the number of white infants placed for adoption has dropped, as single white women join black women in choosing to keep their children. A 1996 federal law makes it illegal for agencies to refuse to place a child with parents of another race, and transracial adoptions are on the rise, with celebrities such as Rosie O'Donnell adopting mixed-race children. But in 1998, only 15 percent of adoptions from foster care were transracial or transcultural. The disparity between the demand for white and black babies "is one of the saddest statements about adoption today," says Allan Hazlett, president of the American Academy of Adoption Attorneys.

The discrepancy between supply and demand has escalated adoption prices. Total spending on adoption is rising at 15 percent a year, hitting $1.4 billion in 2000. Although the Nebraska Children's Home Society provides free adoptions to state residents, most private domestic adoptions run from $6,000 to $30,000. Foreign adoptions run higher, starting at $15,000 for China to well over $20,000 for Guatemala. Randy and Barbara Combs figure it will have cost them $25,000 to $30,000 to adopt Viktoria, once travel costs are included. By far the biggest chunk, the $14,000 foreign fee, went to Frank Foundation Child Assistance International, a Washington, D.C.-based organization that is one of the largest locating children in Russia. In 1998, Frank made a profit of $937,515 on revenues of $4.1 million. Cofounder Nina Kostina earned $197,017. Many adoptive parents are deeply troubled by the vast sums of money they pay and the lack of accountability: "On Sunday I fly into Moscow with $12,000 in cash strapped to my person," says Karen Groth, a 37-year-old Air Force major and intelligence officer who's adopting a baby girl from Kazakhstan. "Where does all our money go?"

Enter the FBI. That kind of unaccounted-for money can't help but draw in a few people with less than pure intentions. Take the much-publicized case of Tina Johnson, the facilitator who is under investigation for placing the twins with two families. U.S. News has learned the FBI is investigating another case in which Johnson, who runs A Caring Heart facilitation service in San Diego, allegedly charged a family $11,900 but never found them a child. Johnson, who did not return calls and E-mail asking for comment, also runs a Web site with the address of www.Iattractmoney.com. There, she pitches get-rich-quick schemes and, until recently, identified herself as "Tina Devereaux, success consultant."

The lure of profit is turning the heads of some potential birth mothers as well. There are at least two former birth mothers in prison for promising their unborn children to several families at once and collecting living expenses from all of them. And adoption chat rooms are filled with sad tales of families who have paid for living and medical expenses, only to have the birth mother exercise her right to change her mind. But those stories give a bum rap to the vast majority of birth mothers. Studies of teen moms show that those who place their children for adoption tend to be older, better educated, and emotionally stronger than those who keep their children.

Still, prospective parents have few legal safeguards. Government officials rarely treat their complaints seriously. Bill Lee, Maryland's adoption licensing coordinator, says when he gets complaints from adoptive parents about money, he makes a courtesy investigative phone call but can do nothing more: "We toss 'em." The state's regulations don't cover such contract disputes, he explains. Other officials move, but glacially. In a lawsuit, Candy and Bob Murdock, a Georgia couple, allege they paid $11,000 in 1998 to Lorraine Boisselle, who ran a Mississippi adoption agency. Two years later, after they say Boisselle gave them increasingly outlandish explanations for her failure to find a child (she once blamed a hurricane), the Murdocks called the Mississippi attorney general's office. They say they were surprised to learn that there were already complaints pending and that Boisselle's license had lapsed. The state says it is still investigating Boisselle. The Murdocks have joined with two other victims in filing a civil suit in an attempt to recover their money. "There is no way you can protect yourself," Candy Murdock says. After her experience, "I would tell anybody considering adoption to go international."

Looking abroad. That's precisely what many people are deciding to do. Over the past 10 years, the number of children adopted from overseas has more than doubled, from 7,093 in 1990 to 18,441 last year, and the numbers are expected to keep rising. Foreign adoption became institutionalized in the 1950s after the Korean War, when Americans began adopting orphans and Amerasian children. But the picture radically changed in the early 1990s. Images of gruesome Romanian orphanages sparked an international effort to rescue children there. The fall of communism in the Soviet bloc paved the way for adoption from Russia and its former republics. And China started allowing foreign adoption of the thousands of girls abandoned by a society that favors male offspring. China and Russia have now eclipsed South Korea as the top two sources of foreign adoptions in the United States, with Guatemala a close fourth. Hundreds of new agencies have sprung up to meet this increased demand.

But foreign adoption, even if it avoids some of the complications of domestic adoption, brings its own difficulties. Two countries' legal requirements must be met, two bureaucracies assuaged. "I applied for a job at the CIA once," Randy Combs recalls. "This was much more paperwork." All adoptions require a home study. Going international requires a dossier of documents for the foreign country and approval by the U.S. Immigration and Naturalization Service. Deanna Hodgin and Philip Dworsky have waited four months for INS approval of their petition to adopt an infant girl from Kazakhstan. Hodgin, a San Francisco communications manager, says she'll quit her job in mid-March and fly to Kazakhstan and wait there: "At least while I'm there I can see the baby each day, feed her some more-nutritious food, and try to improve her condition."

Guesswork. The most daunting, and potentially devastating, hurdle in international adoption is assessing a child's health in the face of incomplete or faulty medical information. Nobody wants to go through what Debbie and David Crick of Apison, Tenn., have. They adopted a boy they thought was 10 years old from the Republic of Georgia in 1996, only to find out he was actually 14 and seriously mentally ill. In the case of Randy and Barbara Combs, the couple know nothing about their daughter's birth father and little more about her birth mother, a 20-year-old shop clerk who left the newborn at the maternity hospital. Prospective parents typically receive a short video of a child and a synopsis of the medical history. Little Viktoria's analysis included neurological terms like "pyramidal insufficiency" and "perinatal encephalopathy." "It's very scary," says Barbara. The Combses took their video and report to a pediatrician, and also called the orphanage's doctor with the help of a translator. "She's good kind baby," the doctor said. The couple started packing for Siberia.

Most children coming to the United States are from countries like Russia with poor medical systems, where pregnant women often get no prenatal care and are malnourished. Children adopted from abroad also often suffer ailments that a suburban pediatrician wouldn't even think to look for, including syphilis, tuberculosis, intestinal parasites, and hepatitis B and C.

Those health problems are exacerbated in orphanages, where children are often underfed and the lack of individual attention delays physical and mental development. In a study published last year, 75 percent of children adopted from China had significant developmental delays. (Korea and Guatemala are considered exceptions, because children are placed in foster care instead of in orphanages and usually get good medical care.) "These kids are high risk," says Ronald Federici, an Alexandria, Va., neuropsychologist who treats foreign adoptees. Many agencies, he says, require parents to sign liability waivers, which absolve the agency of responsibility if the child later turns out to have serious medical or psychological problems.

Indeed, Frank Foundation's Nina Kostina says that parents need to be ready to bail out: "When the parents are in the orphanage with the medical records in front of them, this is the time. Call your pediatrician in the United States. This is a lifetime decision."

Given the emotional investment, that's not easy. Barbara Combs says she doesn't think she would have had the strength to say no once she'd made it all the way to Novosibirsk, after an overnight flight from Moscow. Fortunately, she felt she didn't have to. The medical information from the orphanage doctor matched what she'd heard before, aside from a "peculiarity of the coccyx." The translator started dictating a letter to the court, as Randy wrote longhand: "We have met the child and bonded with her. We are aware of her health concerns."

Heading home. Two days later, Barbara and Randy were standing before a Siberian judge, who after 40 minutes of questions declared that Viktoria Nikolaevna Istomina was now Victoria Nicole Combs. Three days later, the sleep-deprived family was on the plane for home, surrounded by other adoptive parents with wailing babies. Victoria was diagnosed with a mild case of rickets due to lack of vitamin D, and her family doctor said the "peculiarity of the coccyx" dismissed by the orphanage doctor may require surgery. But her exhausted parents remain pleased. "Considering you're going to another country and taking guardianship of another human being," Randy says, "it's been amazingly smooth."

Just last Tuesday, Victoria made history as she and about 75,000 other children adopted from abroad instantly became American citizens, thanks to the Childhood Citizenship Act of 2000, designed so that foreign adoptees would not risk being deported if their parents failed to have them naturalized. Children adopted abroad now become citizens once they enter the States. That, and pending legislation that would raise the federal tax credit for adoption from $5,000 to $10,000 per child, are hailed by adoptive parents and advocates as significant steps toward encouraging adoption. The third step is more significant still--the Hague Convention on Intercountry Adoption. Last year, after a decade of effort, Congress approved legislation to implement the international treaty, which is designed to stop trafficking in children and promote international adoption. For the first time, the United States will have a central authority that will accredit adoption agencies and a federal database. "If there are enough complaints about an agency, that agency could be removed," says Mary Marshall, director of the office of children's issues at the State Department. It will take up to three years for the central authority to be created, but once it's online, prospective parents will have for the first time a central source of information on agencies, one that should prove useful to parents adopting domestically as well.

In the meantime, adoption advocates say parents should use their heads, not just their hearts, when seeking a child. "If you were buying a car, you wouldn't plunk down your $45,000 without looking it up in Consumer Reports," says Jerri Jenista, an Ann Arbor, Mich., pediatrician who has been practicing adoption medicine for 20 years and who has adopted five children from India. "I see people who adopt a child for the same amount of money with zero preparation. You have to do your homework."

Adoptions from abroad

Here are the top five countries of origin for orphans adopted and brought to the United States.

[Chart data are not available.]

[Chart labels] China, Russia, S. Korea, Guatemala, Romania; 1992, 1994, 1996, 1998, 2000

Adoption online

Internet sites on adoption abound. Among the most helpful:

www.calib.com/naic/ The National Adoption Information Clearinghouse provides an unbiased take on all types of adoption.

www.nacac.org The North American Council on Adoptable Children tells how to adopt children in foster care.

www.law.cornell.edu/topics/adoption.html Links to just about every adoption law on the state and federal books and to key court rulings.

This story appears in the March 12, 2001 print edition of U.S. News & World Report.

2001 Mar 4