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).

Usually, semi-open refers to an adoption in which the adopters and birthparents meet once or twice and on a first-name-only basis. In addition, they may agree to exchange pictures and letters on an annual or fairly infrequent basis through the adoption arranger. (If your adoption arranger advocates a semi-open adoption, be sure to ask for an exact definition of her terms.)
Females have statistically been somewhat more likely than males to search for their birth parents, and are far more likely to search for their adopted children. Very often, the reason the infant was put up for adoption in the first place was the birth father's unwillingness to marry or otherwise care for the child. Nevertheless, many birth fathers in this situation have agreed to meet with their grown children decades later.[citation needed]
There are also private search companies and investigators who charge fees to do a search for or assist adoptees and birth mothers and fathers locate each other, as well as to help other types of people searching. These services typically cost much more, but like search organizations and search angels, have far greater flexibility in regards to releasing information, and typically provide their own intermediary services. However, they may not circumvent the law regarding the confidentiality process.

In all adoption searches, it is uncommon to find both the birth mother and father at the same time. A separate search, if desired, can be done afterwards for the father. Since males seldom change their surnames, and the mother might have additional information, it is usually easier than the initial search for the birth mother. In many cases, adoptees are able to do this second search for their birth father by themselves (or they try before paying for assistance).

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