Although practices vary state by state, most adoptions start with the birth mother reviewing dozens of adoption profile books  or online profiles of prospective adoptive parents. Usually, these are adoptive families who have retained that agency or attorney to assist them in the adoption process. Most US states permit full openness not just regarding identities, but also personal information about each other. Just as the adoptive parents want to learn about the birth mother's life and health history, so does the birth mother want the same information about the people she is considering as the parents for her child.
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Now that the first open-adoption generation is under way, social workers are becoming more aware of the role of siblings in these arrangements. An adoptive child’s relationships with biological siblings need to be taken into account. And two children adopted into the same family may have different degrees of openness with their birth mothers. Openness may also affect decisions about family size.
Closed adoption refers to an adoption process where there is no interaction of any kind between birth mothers and prospective adoptive families. This means that there is no identifying information provided either to the birth families or adoptive families. However, non-identifying information such as physical characteristics and medical history may be made available to those involved.
For many years in New York State, adoptees had to obtain the permission of their adoptive parents (unless deceased) to be included in a state-sponsored reunion registry regardless of the age of the adoptee. In some cases, older adults or even senior citizens felt like they were being treated like children, and required to obtain their parents' signature on the form. In a broader sense, they felt it could be inferred that adopted children are always children, and thus second-class citizens subject to discrimination. The law has since been changed.
Most open adoptions lie somewhere in the middle, according to Grotevant and McRoy, exchanging letters, pictures, and phone calls, and having face-to-face meetings once or twice a year. Whatever their situation, many families report that relatives and friends condemn openness, and voice fears that the arrangement will make the birth parent want the child back.