Crafting a Goodbye in Open Adoption-The Hospital Plan

Fact Sheets


Hospital Plan in Open Adoption

Sensitivity and flexibility are key to creating a hospital plan in open adoption.

The Creating a Family show yesterday was on creating a hospital plan in open adoption. One of our guests, Rebecca Vahle, the adoption coordinator at a Colorado hospital, said that the goal of any hospital plan in adoption is to respect the first parents and allow them to “craft their own good-bye”. That beautifully sad image has stuck in my mind.



The key is for all parties to remain flexible. No one can anticipate how they are going to feel after the birth of a child, and this is especially the case when a mom is considering placing her child for adoption. It’s hard to imagine a more emotionally fraught time.

As Dr. Jennifer Bliss, the National Associate Counseling Director at the Independent Adoption Center, said on yesterday’s show, this is a time of high and often conflicting emotions. One father told her that the hospital room felt like both a wedding and a funeral. Adoptive parents should follow the lead of the expectant parents/new parents.

10 Steps to a Successful Hospital Experience in Open Adoption

The hospital plan is essentially the expectant mom’s plan. It’s her pregnancy, her delivery, and her baby. We hope that the adoption agency counselor is working with her to help her create the best plan for her and her child. This is a delicate place for a hopeful adoptive parent to be. Here are 10 things adoptive parents can do or encourage the expectant mom or her social worker to do.

  1. Prepare yourself ahead of time for changes. A hospital plan is a blueprint, not a contract and will likely change. No one knows how she will feel or what she will want in this emotionally charged time, so be prepared to remain flexible.
  2. If the mom knows what hospital she will deliver at, about a month before the birth she or her social worker should contact the hospital social worker to talk about the hospital plan that has been discussed between the expectant parents and adoptive parents. Take this opportunity to explain open adoption.
  3. They should ask what adoption related services are provided by the hospital and if the staff has had any specific training on adoption sensitivity? (The answer is likely “no”.)
  4. If the expectant mom wants the adoptive parents to be fully involved at the hospital, she or her social worker should send the following to the hospital social worker and ask for it to be included in her file.
    • The hospital plan that has been worked out between the expectant parents and the adoptive parents.
    • The HIPAA release form if the expectant mother has signed one.
    • A cover sheet with contact information for the social worker and the adoptive parents.
    • Some adoption agencies recommend including the Dear Expectant Parent letter that the adoptive parents have prepared as a way to introduce the adoptive parents to the hospital staff that will be working with the new mom.
  5. If it is OK with the expectant mom, the adoptive parents should keep a copy of the above package and bring it with them to the hospital.
  6. Adoptive parents can ask the hospital social worker what they should bring to the hospital for the baby? Diapers? Clothes?
  7. If you hit a snag with the hospital staff or with changes to the hospital plan, leave decisions in the hands of the expectant parents or new parents.
  8. If the expectant parent or new parent tells you that they are being pressured by the hospital staff to either go through with the adoption plan or to not place for adoption, tell your adoption professional/social worker. He or she may need to speak with the Charge Nurse or Supervisor.
  9. This is an intensely emotional time for both sets of parents and misunderstandings are common. Work very hard to communicate, ask questions, and avoid making assumptions. Give the parents space to decide if adoption is still their choice and give them time alone with their baby. When in doubt, ask.
  10. After discharge, give the hospital feedback on your experience and on how the staff handled this emotionally charged time.

What was your hospital experience like?


Image credit: sean dreilinger

03/04/2014 | by Fact Sheets | Categories: Adoption, Adoption Blog, Blog, Other Adoption Resources | 6 Comments

6 Responses to Crafting a Goodbye in Open Adoption-The Hospital Plan

  1. Avatar Robyn C says:

    But what if the expectant mother doesn’t *want* all of this to happen? Some e-moms/new moms don’t want the hospital to know they’re doing an adoption at all. That’s their right. Wouldn’t the PAPs contacting the hospital about a specific e-mom violate HIPAA? At the very least, it is an invasion of her privacy.

    • Robyn, the adoption professional should discuss with the expectant parents what they think they will want while at the hospital and then communicate this to the hospital social worker, if the expectant parents want her/his help. Some expectant parents are quite capable and willing to advocate for themselves. And yes, I believe that many agencies get a HIPAA release form from the expectant mom if she wants the adoptive parents to be given medical information on the baby.

  2. Avatar Robyn C says:

    Oh, I know they drop the ball. They (well, the facilitator) dropped it, big time, with DS. I just think that encouraging PAPs to contact the hospital about a specific expectant mother is way overstepping their boundaries.

    • The goal is to have the adoption professional be doing the contacting. However, we hear from some adoptive parents that no one other than them was available to advocate for the birth family/expectant family and the family wasn’t in a position to advocate for themselves. I would hope and wish that all expectant families have someone from the agency or their counselor available to help them before, during, and after the hospital.

  3. Avatar Robyn C says:

    The recommendation is that the prospective adoptive parents contact the hospital social worker, yes? I agree that that seems like a good idea. (It certainly would have helped us, our son, and his birthmother.) However, it’s also presumptuous. The expectant mom may not want the hospital to know she’s considering an adoption plan. Sadly, far too many hospitals treat new moms who are considering adoption terribly.

    I’d rewrite the recommendation to be more generic. Ask the hospital what happens, in general, when an open adoption plan may be in place. Ask what training they’ve had. BirthMom Buds has a great pamphlet that introduces adoption-related hospital issues. Send a few copies of that over.

    Honestly, I don’t think that the PAPs have any business being at the hospital during labor and delivery unless the expectant mom truly doesn’t have any other support and wants them there. Even then, I’d make sure that the e-mom knows it’s her choice and that she’s not being pressured. The agency social worker and e-mom are the ones who need to take the lead. The PAPs need to know what’s going on, but I really don’t think it’s their place to call the hospital and set everything up.

    • Robyn, in an ideal world the contact, arrangements, etc. would be done by the adoption agency social worker. I agree that the prospective adoptive parents’ role at the hospital should be limited. Sometimes, however, agencies drop the ball.

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