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Thinking About Adoption: FAQs

​​By: Elaine Schulte, MD, MPH, FAAP

Choosing to adopt a child is a big decision and is a beautiful way to create or add to a family. Below you will find the answers to some commonly asked questions.

Q: I think I want to adopt. Where do I begin?​

A: Thinking about adoption can be an exciting and overwhelming process, and with more than 125,000 children adopted in the United States each year, it's obviously become a popular option. Adoptive Families is an award-winning resource for parents-to-be navigating the adoption process and for parents raising children through adoption. Learn more about their How-to-Adopt and Adoption Parenting Network.  

Q: What are the different types of adoption?

A: Children can be adopted through the national public child welfare system, private agencies, existing relationships, or the international process.

  • In a public adoption, the child is placed in a home by an agency that is either operated by the state or contracted by the state. Public adoption requirements can vary by state.

  • In a private adoption, placement is made by a nonprofit or for-private agency. Parents typically use an agency to assist with an international adoption.

  • An independent adoption may be carried out by birth parents, a lawyer, a doctor, a religious leader, or any other person who can help connect a child with a family.

For private and independent adoptions, the birth parent(s) can decide whether or not he or she wishes to select the adoptive parents, meet with them, even maintain an ongoing relationship, if he or she so chooses. That is called an open adoption. In a closed adoption, the names of the birth mother and father and the adoptive parents are not shared with one another.

Q: What is the average cost of adopting a child? 

A: The costs really depend on the type of adoption, and, to some extent, the length of time it takes to adopt. Costs can range from $0 to $50,000. Child Welfare Information Gateway has an excellent review of adoption costs with references. Many employers also offer adoption benefits to help offset the cost. In 2013 the Federal Adoption Tax Credit was created to help families cover the adoption costs, as well.

Q: How long does the process of adopting a child typically take?

A:  Parents hoping to adopt need to be prepared for a long and bumpy ride. Again, the length of time varies based on the type of adoption. Adopting a newborn from the United States can sometimes be extremely quick and/or could take years. The length of time to adopt internationally also varies based on the country and the referral process. Adopting a child internationally who has special medical needs can happen within 2 to 3 years. Adopting a child from foster care may not take quite as long, but it can be more complicated.

Q: There are so many adoption agencies out there, how do I know which I should use?

A: Selecting an adoption agency requires patience and perseverance. It's important that prospective parents do their homework. This may start with an internet search. Parents should look for an experienced agency and make sure the agency's values align with their own. Agencies should be willing to share references. Talk to friends and colleagues about their experiences, as well.

Q: Where can I learn more about the laws governing adoption?

A: Information about adoption laws can be found on the Child Welfare Information Gateway, which is a service of the Children's Bureau in the U.S. Department of Health and Human Services. 

Q: What sort of preparation do I need as a prospective adopting parent?

A: As you consider the type of adoption you are going to pursue, you will need to get ready to be an adoptive parent. There is no "one size fits all" preparation that provides exactly what you need. Many agencies offer pre-adoptive training for prospective parents. For children who are adopted from foster care, there may be mandatory certification or training. Talk to families who've already adopted and gone through the process. Familiarize yourself with all the legal, financial, medical, developmental, and behavioral issues related to adoption.

Q: How will I talk about adoption with my friends and family?

A: If nobody in your family or circle of friends has adopted a child, it can be difficult to broach the subject. There are a lot of misconceptions about the adoption process and adopted children in general, and talking about it will invite people to voice what they know.'s article, Respectful Ways to Talk about Adoption: A List of Do's & Dont's, will help you learn the lingo, think about what you'd like to use, and educate your family and friends.

Q: What are the common medical and developmental concerns facing adopted children?

A: Many adopted children have unique medical, mental health and developmental needs that are rooted in their prenatal and pre-adoption histories. These needs may be present prior to, or at the time of adoption, or they may not appear for several to many years after adoption. ​

Additional Information from

About Dr. Schulte:

Elaine E. Schulte, MD, MPH, FAAP is a board certified pediatrician and Professor of Pediatrics at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. She is the Medical Director of the Adoption Program at Cleveland Clinic Children's and has cared for hundreds of families and children touched by adoption. She also provides pre-adoption consultation service through MyConsult. Within the American Academy of Pediatrics, Dr. Schulte sits on the Executive Committee of the Council on Foster Care, Adoption, and Kinship Care. She is the parent of two children adopted from China.

Elaine Schulte, MD, MPH, FAAP
Last Updated
American Academy of Pediatrics (Copyright © 2017)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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