Laurie Q&AQ & A with Laurie

Hello everyone, my name is Laurie Walker, and I am an Adoptive Family Specialist with American Adoptions. I have worked with many birth mothers and adoptive families in my time here at American Adoptions and love being able to watch families form through adoption.

Q. We are an active family with American Adoptions and are wondering what say (if any) the adoptive parents have in the medical choices regarding the newborn baby at the hospital? In other words, if the adoptive parents have strong preferences regarding circumcision, Vitamin D shots, drops in the eyes, newborn testing, etc. to what extent are their wishes honored? And how can adoptive parents let their wishes/ preferences be known? Thanks so much!

A. In most circumstances, the birth mother will need to sign for all medical decisions made for the baby while in the hospital as typically she still holds custody of the baby during that time frame. She’ll need to sign off on all procedures until she is capable of signing a relinquishment/consent for adoption. Prior to the baby’s birth, the birth mother will make a hospital plan with her Adoption Specialist and one of the questions during that plan is if she has a preference on if the baby can be circumcised or not. Sometimes, birth mothers have strong opinions one way or another about this topic while other times they’ll leave it up to the Adoptive Parents.

If it is your wish to have the baby circumcised and the birth mother too agrees, the birth mother will sign the consent to have this procedure completed in the hospital. In an instance where the birth mother does not want this done or for any other reason it cannot be done, the adoptive parents will need to schedule an appointment to have this done outside of the hospital after they have gained custody. In some circumstances, hospitals will not complete a circumcision on a child if they know it’s an adoption decision even when all are in agreement to have it completed. In that type of scenario, waiting to have the procedure done at a later date is also necessary. It’s also important to note that often Medicaid and other insurance companies will not identify a circumcision as a medical necessary procedure and will code it as cosmetic making this an added cost to the family. Similar, other medical decisions would be the birth mother’s to make up until her consents are signed.

If the adoptive family’s decision differs from the birth mother’s that discussion should occur with the social worker from our agency and not the birth mother. The social worker can make the choice if and how to have that discussion with the birth mother so as not to jeopardize the adoption but still have the wishes of the adoptive family known to the birth mother. However, in the end until the consents are signed, the birth mother’s wishes will have to be honored.

After the Adoptive Family receives temporary custody of the baby, medical decisions can be made without the birth mother’s consent by the Adoptive Family. If the adoptive family feels there should be additional medical testing above and beyond what the hospital deemed appropriately needed after birth, it would be outside of the hospital with the adoptive family’s own pediatrician where this would need to occur.