In some states, (North Carolina, Georgia, Virginia) the city and county of the adopteeā€™s birth is changed on the amended birth certificate, to where the adoptive parents were living at the time the adoption was finalized. Often, the states will not give the adoptee the correct location of their birth. Some adoptees have been denied passports for having incomplete birth certificates. The hospital may also be omitted on the amended birth certificate, especially if it primarily serves unwed mothers. In the United States, many such hospitals were run by the Salvation Army, and named after its founder, William Booth. By the mid-1970s, all of these hospitals had closed due to high costs and the reduced need for secrecy, as the social stigma of having a child out of wedlock in America had decreased. More and more mothers were raising their child as a single parent (often with the help of the newly created institution of government welfare).
Many states, though, still keep this information sealed even after the adoptee and the birth parents agree to know and contact each other. A second court order would be required to have this information unsealed permanently. This is well beyond the scope of the initial search, and what is covered by the payment to the intermediary. Should an adoptee subsequently lose his or her unamended birth certificate, a court order may be required to obtain another one (even if a photocopy is submitted).

Closed adoptions are rare in the United States, but remain common in international adoptions and were the norm in adoptions in the past, when families usually used an agency to adopt a newborn. The prospective adoptive family would put their name on a list, and wait for the social worker to make a match. The adoptive parents didn't know where the child came from, or who his or her birthparents were. The child might not have even known that he or she came into the family through adoption.
Closed adoption, not to be confused with sealed records, is an adoption in which the adoptive family and the birthmother never meet and know nothing or very little about one another. With the advent of open adoption, closed adoptions have become the exception in domestic adoption rather than the rule. The term closed adoption is most often used in relation to post-adoption contact, whereas the term sealed records is related to the access of legal documentation surrounding the birth and placement of the adopted child once the adoption is final. It is entirely possible to have a closed adoption and unsealed records or an open adoption with sealed records. The two practices are not mutually exclusive.