Open vs. Closed Adoptions: A Post Adoption Mental Health Perspective

Thank you very much to the BPAR clients who shared their stories anonymously so we could illustrate this important topic.

The decision to make an adoption plan for your own child, or the decision to adopt someone else’s child, is complicated and full of nuance. One of the many issues involved with an adoption plan is the decision around maintaining an open adoption or closed adoption. Over the years, Boston Post Adoption Resources has noticed a shift in the number of adoptions that include some type of contact with birth family members. This shift toward open adoptions has evolved over the past 25 years due to information from adult adoptees as well as new research in the field. Many factors come into play when an adoption plan is made, decisions around open and closed adoptions are complicated, and every adoption story is unique.

Throughout it all, access to education, support and post adoption services are key to helping families navigate the unique issues around birth family contact that might arise throughout their lives.

BPAR’s Experience with Open and Closed Adoptions

Mental health clinicians at BPAR work with all members of the adoption triad. Some of the people we work with have had open adoptions, some have had closed adoptions and decided as adults to search for birth family members, and some have decided not to search at all. Each story is unique. Throughout their lives, children and adult adoptees grapple with questions about their birth family origins and identities. They wonder about who they might have inherited their singing voices from, they wonder about their blue eyes or about their medical histories. They wonder why their birth parents decided to make an adoption plan for them.  Micky Duxbury writes in her book, Making Room in Our Hearts (p.2), “In order to know who you are, you need to know something about where you came from; in order to move into the future, you have to be able to claim your past.”  Many adult adoptees have spoken to us about difficulties they experienced as children when their birth family and adoption story was not acknowledged or discussed in the home. They felt as if their adoptions were a shameful secret that they could not talk about, and they sometimes felt disloyal if they were curious about or wished to meet their birth families. They struggled with wanting to honor their adoptive parents but also wanting to know about their past and meet their birth families.

Adoptive dads Zhang and Michael adopted their now 10-year-old son, Sam, at birth (names and identifying information have been changed). The adoption plan allows for 2 visits with the birth family each year. Zhang and Michael report that birth family visits have been “on the whole very positive,” in spite of the ups and downs. They feel that Sam’s birth family contact has allowed their son to “learn who he is and have his questions answered.” They anticipate that Sam will have more questions as he grows, and on-going contact will help answer these questions. They add, “This is preferable to the alternative – to never hear from them again. We are glad that we have this model. It seems more fair to Sam.”

Christina, 22, was adopted from foster care when she was around four months old. At the time, her adoptive family was living in the Midwest, close to Christina’s birth parents, who were in their early 20’s when she was born. Christina had frequent visits with her birth parents, as often as every other week, when she was an infant. Later, when Christina was around three and the family moved to the East Coast, she and her parents flew to visit birth family members around once a year. She speaks positively of her open adoption, but adds that it was not without its challenges. Her birth family has a long history of adoption (including her birth mother, who was adopted from China) as well as substance abuse, and she has not always had direct contact with her birth father, who has been in and out of jail. Christina states, “Being adopted in general is so challenging, there is so much to unpack. If I had needed to wait until I was 18 to meet my birth family and find out all the crazy, it would have been way too much at once!” Christina learned more information as she grew older, and her adoptive parents were very supportive, helping her navigate the ups and the downs, and helping her to make sense of new information. She says, “It would have been harder if they were hesitant. They were always unwavering and supportive. That helped me not feel guilty about wanting a relationship with my birth family.”  One of the hardest parts about birth family contact for Christina has occurred more recently. She feels that since she is now over 18, she would like to navigate the birth family contact with less help from her adoptive family. “I have been shifting from relying on my parents to making more of my own choices. I am the decision maker.” One of the most difficult things that Christina has grappled with has been “survivors guilt.” She sees how her biological brothers, who grew up with her birth mother, have not had the same life as she has, and she struggles with guilty feelings around this.

Although there needs to be more research addressing adoption in general and open vs. closed adoptions in particular, the current research does shed some light on the shift toward more open adoptions. In the past, it was felt that a closed adoption would lessen the amount of shame the adoptee might feel. Some of this sentiment was based on the misconception that unwed mothers were somehow shameful or scandalous (Martha et. al., 2009). As a result of this secrecy, however, the children were not able to understand their story or where they come from. Zhang and Michael addressed this notion when they spoke with me: Their open relationship with Sam’s birth family “sends the message that there is nothing to be ashamed of.”

Susan, 55, was adopted in 1964 when most adoptions were closed. She states that her adoptive parents preferred this closed model because “they wanted to pretend I was their birth daughter.” Her family’s tendency toward silence and secrecy felt very powerful throughout her childhood. Susan feels that her parents felt shame due to their infertility, and the family never talked about the adoption as she grew up. At the same time, other people did know about this “secret,” and Susan remembers being teased about her adoption by her cousins growing up. “I always felt isolated, as if I did not belong.” This culture of secrecy was so powerful that even the nuns illegally changed Susan’s paperwork at the time of her adoption, adding misinformation to her records. As an adult, Susan realizes how impactful it would have been if her family had not tried to hide the truth about her adoption. She recommends that “the whole family have an open dialogue about adoption. The more you talk about it, the more confident you are with it. It helps you become really comfortable with your story.” Ben, a 29-year-old adoptee interviewed for Micky Duxbury’s book Making Room in Our Hearts (p.16), comments, “If I knew who my birth mother was, I could have stopped the fantasizing and wondering….I could have just asked her those questions instead of just having them bounce around in my head for all those years.”

Research on the Lifelong Impact of Open Adoption

The Donaldson Institute published a study in 2012 entitled “Openness in Adoption: From Secrecy and Stigma to Knowledge and Connections.” The authors estimate that in 2012, only about 5% of domestic adoptions were closed adoptions. The rest were considered open adoptions in that the adoptive family had some level of ongoing relationship with birth family members. This interaction could entail email contact, sending yearly pictures and updates, or visits. The authors note that, in most infant adoptions, the birth mother picks the new family for her baby. In fact, in infant adoptions, it is becoming more common for adoptive parents to meet the birth mother prior to or during the birth. For the adoptive parents, “more openness is…associated with greater satisfaction with the adoption process.” In addition, birth mothers who have ongoing contact with their children “report less grief, regret and worry, as well as more peace of mind.”

Adoptive parents sometimes worry about birth family contact, and they might fear that birth family members might try to reclaim their child. However, our clinical experience has been that open adoptions often dissipate these fears and provide a place for the child to better understand the reasons for the adoption and their own history. Research has found that openness has resulted in less fear on behalf of the adoptive parent, greater empathy for the birth parents, and stronger communication between the adoptive parents and their child. Zhang and Michael state: “Watching Sam develop a relationship with his birth mother and father, seeing how much he enjoys seeing them, that has been powerful for all of us.” They have wondered if Sam’s birth parents might feel some sadness that they are not parenting Sam, but they feel this is offset by the possibility that “they could conceivably have a lifelong relationship with him.” They add, “It is always clear that they love him, and they seem to feel happy he’s thriving.” Susan knows that sometimes adoptive parents worry that their children will “like their birth parent more than them.” But, she points out, “A parent can love more than one child; why can’t a child love more than one parent?” Christina adds, “At the end of the day, my parents knew they weren’t going anywhere. They told me, ‘We believe you have a big enough heart to love all four of us’.”

Research suggests that adolescents who have ongoing contact with birth family members are more satisfied with their adoption than those who have no contact. As teens begin to grapple with identity issues and wonder about their histories, contact with birth family members allows them to better understand their stories, including the reasons for their adoption. Christina states it has also been helpful to be able to ask her birth mother questions about their family history. For example, when Christina was struggling with anxiety and depression and considering medication, it was helpful to talk to her birth mother about her own history of anxiety and depression and which medications worked for her. A 2006 study published in Child Welfare, “Adolescents’ Feelings about Openness in Adoption: Implications for Adoption Agencies,” interviewed 152 adolescents and found that those who had ongoing contact with their birth parents were more satisfied with their adoptions than those that had no contact. The growing use by teens of social media and the internet as well as the rise in DNA testing have drastically changed the landscape of birth family contact. The majority of teens have access to the internet and use a social networking site. Some of these teens might search for birth family members without accessing the support or help of their adoptive families or professionals. Susan remembers sneaking into her parents’ bedroom when they were out and looking at her adoption records. She had no one to talk with about what she saw in these records due to the atmosphere of secrecy in her home.

Challenges and Benefits of Open Adoptions

There are many challenges to open adoptions. A birth parent may disappear for a while with no explanation. They might not follow through with the visitation plans. There are many possible reasons for this withdrawal, including relapse, incarceration, shame and sadness. There are also cases where openness is not appropriate. Christina’s birth father, who she describes as having very poor boundaries around their contact, kept trying to meet her while in and out of jail, and her parents needed to set strict boundaries and at times limit or stop contact until it was appropriate for Christina. Through it all, it is helpful to remember the goal of this contact: meeting the needs of the child. Helping the child process his or her feelings about these meetings and changes in their frequency is essential. It is important to remember that everyone involved has their own journey, with its ups and downs. People change over the years, and children’s developmental needs evolve. Feelings of loss, grief and identity concerns can be persistent. Susan remembers that she was always a bit immature for her age, and she struggled with social skills. “I always felt there was something wrong with me.” She recognizes that her birth family’s circumstances might not have been appropriate for regular visitation, however she feels that some type of contact would have been helpful. Though it might have been best to limit contact to letters, she feels those would have been helpful to answer some of her questions. She recommends “giving children their story from the beginning.” Every story is different, and as we’ve demonstrated in our book Adoption Is a Lifelong Journey, children can be given more information as they grow.

Zhang and Michael spoke about the challenges of open adoption as well as the benefits. They think it is important to “be honest with yourself about your emotions. Not all visits will feel positive and that’s OK.” They remember feeling “a bit threatened” during the early visits, and it took some time to become really comfortable. They had to remind themselves, “These are his birth parents, they love him and want to be in his life.” They recommend keeping the “big picture” in mind and remembering, “This is not about you. It’s only about the child.” They stress the importance of seeking help and support to get through the more difficult times. Zhang and Michael have felt that the support they have received through BPAR has been invaluable as they navigate their son’s adoption journey. They have found it especially therapeutic to talk with other adoptive parents through the parent group at BPAR.

Conclusions About How to Navigate an Open Adoption

So what is the best way to navigate an open adoption? It is helpful to see birth family contact as a “continuum of choices about the amount of contact and shared information between the child and birth family.” (CASE webinar, Navigating Relationships in Open Adoption). Adults can provide new information about birth family over different developmental stages. The relationship and the variables can unfold over time, as more trust develops. Remember that the plan for family contact can change as the child grows or birth family circumstances shift, and the primary focus is managing this process with the best interests of the child in mind.

Written by Erica Kramer, MSW
Boston Post Adoption Resources


Berge, Jerica, Mendenhall, Tai J., Wrobel, Gretchen M., Grotevant, Harold D. and McRoy, Ruth G. 2006. Adolescents’ Feelings about Openness in Adoption: Implications for Adoption Agencies.

Duxbury, Micky. Making Room in Our Hearts. Routledge, 2006.

Henry, Martha and Pollack, Daniel. Adoption in the United States: A Reference for Families, Professionals and Students. Oxford University Press, 2009

Siegel, Deborah H., Smith, Susan Livingston. Evan B. Donaldson Adoption Institute. Openness in Adoption From Secrecy and Stigma to Knowledge and Connections. March, 2012

Singer, Ellen. C.A.S.E. webinar Navigating Relationships in Open Adoption. July, 2019.

About Erica Kramer, MSW

Erica Kramer, MSW, is the former Operations and Intake Director at Boston Post Adoption Resources.