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How to Create a Friendly Hospital Adoption Policy

Adoption is a process that brings people together: prospective birth parents, adoptive families, children, and the various professionals needed to make an adoption happen. It truly takes a village.

Because most private domestic adoption placements happen in the hospital shortly after birth, hospital staff — nurses, physicians, hospital social workers and admin staff — are among the professionals that play such a vital role in this process.

That’s why it is crucial to have adoption-friendly policies and protocols in place for everyone in the hospital to follow.

As a leading national adoption agency, American Adoptions completes hundreds of adoption placements each year. We work with hospitals on a daily basis to support women and families through this process.

In this guide, we will provide recommendations to incorporate into your hospital adoption policies and protocols, so you can be better prepared to support prospective birth parents and adoptive families.

If you need to speak with someone about an adoption plan for one of your patients, you can call us any time at 1-800-ADOPTION to speak with a licensed social worker who specializes in adoption. We are always happy to answer any questions and support you and your patients in whatever way we can.

In the meantime, here are some things to include in your hospital adoption policy:

Guidelines for Hospital Social Workers

Often, women considering adoption will contact a licensed adoption agency during their pregnancy to create an adoption plan. During this time, they receive specialized counseling related to the adoption and make all the important decisions about how they’d like their adoption process to go, including:

  • Choosing an adoptive family for their baby

  • Determining how much contact they want to have with the adoptive family during the adoption process, as well as the type of relationship they want with their baby and the adoptive family after the adoption

  • Developing a hospital plan, which includes information about their desires for their hospital experience

  • And more

In these cases, the adoption agency worker will be the pregnant mother’s main point of contact related to the adoption process. If the prospective birth mother is working with a national adoption agency, she will often also have a local adoption worker who will be available to provide additional, in-person support. As a hospital social worker, your first step should always be to determine whether the patient has already worked with an adoption agency to develop an adoption plan. If so, your responsibility, first and foremost, is to respect this adoption plan and ensure the prospective birth mother’s wishes are met.

Here are some additional steps you can take to support patients considering adoption in your hospital:

Step 1: Ask the prospective birth mother if she is working with an adoption agency.

If so, ask her if she’d like you to contact the agency to notify them that she is in the hospital. If your patient is working with American Adoptions, you can reach her adoption specialist at any time, 24/7, by calling 1-800-ADOPTION.

Step 2: Provide referrals to adoption agencies, if needed.

If the prospective birth mother has not yet contacted an adoption agency, connect her with one. Provide her with a list of available adoption agencies.

If the patient has not already contacted an adoption agency, she can always contact American Adoptions to start the process. Because American Adoptions is the largest domestic infant adoption agency in the U.S., we are best equipped to respond quickly to a prospective birth mother’s needs after she has entered the hospital.

Our licensed adoption specialists are available 24/7 to provide free educational information about adoption as well as options counseling so the prospective birth mother can make an informed decision that is right for her. If and when she is ready to move forward with adoption, we will facilitate the hospital adoption process by:

  • Providing the counseling and support she needs to decide whether she’d like to follow through on the process

  • Sending her the social/medical history paperwork needed to complete the adoption

  • Providing her with profiles of waiting adoptive families who match her wishes

  • Coordinating with the adoptive family she chooses to get them to the hospital as quickly as possible

  • Contacting local social workers and attorneys as needed to provide additional support and services

  • Communicating with you about the prospective birth mother’s needs and wishes during the hospital stay

  • And more

As a national adoption agency, we often also partner with local social workers who can be available to the prospective birth mother for in-person support. Between these local workers and our 24/7 availability, we ensure every woman has the support she needs during this highly emotional and sensitive time.

To get in touch with an adoption specialist now, call 1-800-ADOPTION, or encourage the prospective birth mother to call 1-800-ADOPTION to reach a licensed professional immediately.

Step 3: Document the adoption plan.

Make a note in the patient’s file documenting her adoption plan, the counseling that she received and the agency she was referred to. If possible, include a copy of the prospective birth mother’s adoption plan, which will outline her wishes for her hospital experience.

Step 4: Notify the appropriate hospital staff of the adoption plan.

In addition to notating the patient’s adoption plan in her chart, it is important to develop a system to quickly alert all hospital staff providing care to the prospective birth mother of the adoption plan.

In fact, this may be the most important piece of your hospital adoption policy. Why?

This is an incredibly emotional time for everyone involved — the prospective birth parent(s), their family members, the adoptive family, and potentially even hospital staff. Well-meaning nurses, physicians and other medical staff may make certain comments that can have unintended emotional consequences for the prospective birth mother. Something as simple and well-intended as greeting the prospective birth mother by asking how her baby is doing can create added stress and emotional turmoil for someone going through the most challenging decision of her life.

So, as part of your hospital adoption policy, make it standard practice to discreetly notify hospital staff of a prospective birth mother’s hospital plan. Some ideas for doing this include:

  • Placing an inconspicuous, color-coded sign on the hospital room door.

  • Placing a certain color of flowers in the woman’s room.

  • Sending a message to the prospective birth mother’s care team through an internal notification system.

It is important to ensure every member of the patient’s care team is aware of the hospital plan and to pass this information along between shifts.

Step 5: Work alongside adoption agency staff to implement the adoption plan.

During the prospective birth mother’s hospital stay, adoption agency staff will work alongside you and the prospective birth mother to carry out her adoption plan. To develop an adoption-friendly hospital policy, you should make every effort to respect the prospective birth mother’s adoption plan and accommodate her requests where possible. This may include:

  • Following the mother’s wishes for contact with the baby, which may or may not include seeing, holding, or feeding the baby

  • Following the mother’s wishes for contact with the adoptive family, which may or may not include allowing them in the delivery room, allowing them to provide care for the baby, allowing them to spend time with the baby without the mother, etc.

  • Making accommodations for the adoptive parents as available, such as providing them with a separate room to bond with the baby (as space allows), providing wristbands to allow the adoptive parents to visit the baby in the nursery (with the prospective birth mother’s permission), etc.

  • Remaining flexible and accommodating to the wishes of the birth mother and adoptive family, including after the birth mother has signed adoption paperwork. For example, in cases where the baby has a longer hospital stay or is admitted to the NICU, hospital staff should allow the birth mother to have additional contact with the baby, if the birth mother and adoptive family request this.

Remember, until she signs the adoption consent paperwork, the prospective birth mother is the baby’s mother, and she has all rights and responsibilities for the baby. All decisions regarding her care and her baby are hers to make.

During the heightened emotions of the hospital stay, it is also common for prospective birth mothers to make changes to their established hospital plan. Hospital staff should do their best to be flexible and accommodate these changes whenever possible.  

Step 6: Coordinate with the adoption agency and attorney to facilitate consent signing.

Many prospective birth mothers choose to sign their adoption consent paperwork at the hospital or shortly following discharge. Most states require a mandatory waiting period, often between 12–72 hours after birth, before adoption consents can be signed. However, some states allow consents to be signed directly after birth, and others require a waiting period of up to one month.

This waiting period is designed to give the mother sufficient time to recover from labor and delivery so she can make a final decision about adoption with a clear mind. This consent can be deemed invalid if it is signed under coercion or distress, so it is crucial that hospital staff respect the prospective birth mother’s decision and give her adequate time before signing.

Before she signs her consent to the adoption, the adoption agency will work with you and a local attorney to ensure the prospective birth mother is confident in her adoption decision and that the adoption paperwork is completed legally.

Step 7: Discharge.

Once the birth mother has signed her consent to the adoption and has been medically cleared for discharge, she may be released from the hospital.

Discharge is often the most difficult and emotional part of the hospital stay, and even the entire adoption process, for everyone involved. Hospital staff should be especially sensitive to the birth mother’s needs and wishes during this time, and make arrangements to accommodate for a final goodbye with the baby and adoptive family, if the birth mother requests it. If the birth mother is being discharged from the hospital at the same time as the baby, ask the birth mother if she’d like to leave the hospital before or after the adoptive family.

If the mother is discharged prior to her baby, and especially if the baby has additional medical needs that will require an extended stay in the hospital or NICU, hospital staff should allow the adoptive parents to visit and assume all care for the baby during his or her hospital stay. Hospital staff should also be considerate of the birth mother’s wishes during this time. For example, if she and the adoptive parents request that the birth mother be allowed additional contact with the baby during his or her hospital stay, hospital staff should be flexible and accommodating of this request. 

Responsibilities of Other Hospital Staff in Adoption

If a woman considering adoption delivers when a hospital social worker is not available, medical staff should follow the steps above to connect the prospective birth mother with a qualified adoption agency, if she does not already have one.

Additionally, all hospital staff involved in a prospective birth mother’s care should adopt the following practices and protocols as part of the hospital adoption policy:

  • Be sensitive to the prospective birth mother’s feelings and needs. Remember that while this is the prospective birth mother’s decision, she is experiencing a loss. The hospital stay will be a difficult and emotional experience for her, so exercise kindness, extra empathy and support whenever you interact with her.

  • Be mindful of the language you use. Learning and using positive adoption language can go a long way in caring for birth mothers and women considering adoption. For example, you should always use “making an adoption plan” or “choosing adoption” instead of “giving a baby up for adoption.” Remember that until a woman signs adoption paperwork, she is not a “birth mother” — she is the mom. And, if a patient decides not to place her baby for adoption, she is “parenting” or “raising the child,” not “keeping the baby.”

  • Be respectful and support of the prospective birth mother’s decision. You may have your own experiences, opinions and feelings about adoption, but it is important to remain open, positive, and nonjudgmental at all times. Respect that this prospective birth mother is capable and will make the decision that she feels is best in her circumstances.

  • Follow her wishes as laid out in her adoption plan. To the extent possible, follow the prospective birth mother’s wishes regarding her birth plan, contact with her baby and the adoptive family, etc. Remember that any of the plans made by the prospective birth mother can change at any time, so remain flexible and be respectful of her wishes.

Most importantly, it is every medical staff member’s responsibility to familiarize themselves with their hospital adoption policy and any applicable state laws. For example, it is important to note that hospital staff should never show profiles of potential adoptive parents (other than those sent to the hospital by an authorized adoption agency specifically to share with the prospective birth mother) or to refer a patient to someone they know who wishes to adopt. In many states, it is illegal for anyone, other than a licensed child-placing agency, to “advertise” adoption opportunities or waiting adoptive families in this way.

As a hospital social worker, nurse, physician, or other hospital staff member, you will have a lasting impact on the birth parents, adoptive families and adopted children in your care. By implementing a positive hospital adoption policy and treating every patient with the empathy and respect they deserve, you can make a positive difference in the lives of new mothers, birth mothers and families.


Are you looking for adoption services for a patient considering adoption? Contact us now at 1-800-ADOPTION (236-7846) to speak to an adoption specialist.

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