International adoption requires that families use an accredited adoption agency.  Since each country has specific requirements on what they want in adoptive parents (age, marital status, health, etc.) and different ages of children available, we think it is best to pick a country first and then select an agency. These resources will help:

• Deciding on a Country When Choosing International Adoption (1 hr. radio interview with experts)
• Adoption Comparison Charts for top placing countries to the US (lists parental restrictions, type of kids available, cost, waiting times, etc.
• The Creating a Family 3-Step Process for Choosing an International Adoption Agency

The US State Department lists countries that are currently open to international adoption. The Creating a Family Adoption Comparison Charts analyze the top international adoption countries for 25 factors we think parents should consider when choosing a country including the type of kids available for adoption, the cost, waiting times, and stability of the program.

The cost of international adoption varies significantly by country, and primarily depends on the country fee and how many trips to the country adoptive parents must make to complete the adoption. It is important when choosing a country and an adoption agency to look at total costs. Use this form for comparing agency costs. We include the total cost for the top placing countries in international adoption on our Adoption Comparison Charts.

Wait times for international adoptions have been rising in most countries. It is important when choosing a country to look at how long it has taken families in the last few years. The Creating a Family Adoption Comparison Charts give wait times for the top placing countries in international adoption.

Your adoption agency will be your guide in international adoption, so choose wisely. Creating a Family has a 3-step process for finding an adoption agency, and we include a list of questions that you must ask agencies before you select. We also have a list of red flags for unethical adoption agencies. Note that all international adoption agencies must have Hague accreditation in order to place children to the US.

Children adopted from abroad are at an increased risk for physical and emotional health problems. All potential adoptive families need to think through what type of children they are best able to parent. Not every family is the right family for every child. Creating a Family has many resources listed at the additional resource icons below that can help you decide what you are best able to handle. Here is a sample of what you will find:

• Health Issues to Consider When Reviewing an Adoption Referral or Potential Match (1 hr. radio show with international adoption experts)
• Health Issues with Internationally Adopted Children (1 hr. radio show international adoption experts)
• Feeding Issues and Nutrition in Adoption (1 hr. radio show with an international adoption pediatrician and a feeding expert)

Before accepting, many families choose to have their referrals evaluated by a doctor to help them assess the health risks of the child. Although general pediatricians may be able to help, you might prefer to use a doctor that specializes in international adoption medicine (IA doctors). The American Academy of Pediatrics has a directory of members in their section on adoption and foster care. Members of this section specialize in health issues for children adopted from abroad and keep up with new developments.

It is not necessary that the doctor is located nearby, but some families want to be able to talk with someone in person or take their child for a post-adoption evaluation with the same doctor who reviewed the referral.

Different doctors have different personalities, so talk with them first to see if it is a good fit. When interviewing an IA doctor consider the following questions:

• How many adoption referrals have they evaluated? In the last year?
• How many adoption referrals have they evaluated from my country?
• How long does it usually take to have a referral evaluated if we have medical information before we travel?
• How do they arrange to review data if we receive medical information when we are in-country?
• How comfortable do they feel with diagnosing FAS in a child of ___age and ___ethnicity?
• How much do they charge and what is included? Are phone calls after the initial review included or an extra charge?

When you are in-country to adopt your child, there are specific things you can do to make the transition easier for you and for your internationally adopted child.

• Questions to Ask Your Child’s Orphanage or Foster Home Caregiver
• Promoting Attachment with Your Child While In Country (1 hr. radio interview with experts)
• Bringing Your Adopted Child Home: How To Survive The Trip (blog)

An increasingly common perception based on news reports is that all children adopted from orphanages abroad are damaged beyond repair. Nothing could be further from the truth.

It is very important for adoptive parents to realize that children in orphanages have likely experienced abuse and neglect, and these traumas can have a lasting impact on children, but with good adoption education and support for adoptive families and children, most children and adoptive families will thrive. We have many resources in our section on Attachment Issues in Adoption including:

• Developing Attachment in Adoptive Families (1 hr. radio interview with Dr. Karyn Purvis)
• Attachment Issues When You Adopt a Child Over Two (1 hr. radio interview with Attachment Therapist Deborah Gray)
• The Good News on Research about Toddler Adoption (blog)

Ethical is a loaded word. Of course, there are ethical international adoptions, just as there are some international adoptions that are unethical. The key with international adoption is to provide homes for children who would otherwise not have one, without creating a demand which pulls children from functioning families. There are many children abroad (as well as in the US) who will never have a family if not adopted, and it is possible to adopt these kids while also making all efforts to preserve family units so that children do not need to be adopted in order to be raised in a family. It is important for adoptive parents to think through the ethics of international adoption in general, and the ethics of the country from which they are adopting and the agency they are using in specific. The following resources are a good place to start:

• Ethics of International Adoption & The Orphan Care Movement (blog post)
• Changes in the Christian Orphan Care Movement (blog post)
• Rescuing the Rooftop Folks: International Adoption Neither Saint Nor Devil (blog post)
• What the Heck is Going On with International Adoptions (blog post)

One of the responsibilities of parents who adopt internationally is to help their child identify with their birth culture. These resources can help. We have many more at the icons at the bottom of the page.

• Instilling Cultural Awareness and Pride in Internationally Adopted Children (1 hr radio interview with experts)
• Homeland Tours (blog)
• Cultural Identity and The Internationally Adopted Child (video)