International Adoption

Americans have been adopting children from abroad since the 1950s. While international adoptions have decreased in recent years, primarily due to countries closing their international adoption programs and costs and wait times increasing, it is still a popular choice for many adoptive parents, and there are still many children growing up in orphanages abroad in need of families.

Most of the children available for international adoption are older kids and most have some special needs. If you are trying to decide if international adoption is best for you, check out our Quick Comparison Chart for the Different Types of Adoption.

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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. podcast w/ experts)
Adoption Comparison Charts for the top ten 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 ten sending countries for ten 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. These charts are updated annually.

The cost of adopting from abroad varies depending on the expense of airfare, how long you have to stay in-country, and how much the country charges. The average cost for overseas adoption for the current top three sending countries* is:

Colombia – The Median Adoption Service Provider Convention Adoption Fees in 2022 were $41,432.00 (not including travel or documentation fees). Total ranges vary, with a wide range of costs for travel requirements and sibling group adoptions.
India – The Median Adoption Service Provider Convention Fee for 2022 was $36,122 (not including travel or documentation fees). Total ranges vary, with a wide range of costs for travel requirements and sibling group adoptions.
South Korea – The Republic of Korea is not a Hague-convention nation, so no Median Adoption Service Provider Convention Fee is documented. Adoptive families report that their total costs ranged from $35,000 to $50,000, including all the documentation, adoption service provider fees, travel, and in-country lodging expenses.

*Please refer to the Adoption Comparison Charts for the most updated information on the top ten sending countries.

When choosing a country and an adoption agency, it is important to look at total costs. Use this form for comparing agency costs. We include more information on international adoption costs for the top-placing countries 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 are updated annually to reflect current wait times for the top ten placing countries in international adoption.

Your adoption agency will guide your 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 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 to place children in the US.

Children adopted from abroad are at an increased risk for physical and emotional health problems. All potential adoptive families need to consider what type of children they can best 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 can handle. Here is a sample of what you will find:

Common Special Needs In International Adoption (1 hr. online parenting course by CreatingaFamilyEd.org)
Feeding Issues and Nutrition in Adoption (1 hr. podcast w/ experts)

Please refer to our Adoption Comparison Charts, updated annually to reflect the most common needs of the children available for adoption from each of the top ten sending countries.

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 can help, you might prefer to use a doctor specializing in international adoption medicine (IA doctors). The American Academy of Pediatrics has a tool to find a pediatrician by name, specialty (in this case, Adoption Medicine), and location. Members of this specialty focus on adopted children’s health and developmental issues and keep up with pertinent, new developments.

It is not necessary that you choose a doctor located locally to you, 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.

Doctors have different styles and 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 evaluate a referral if we have medical information before traveling?
How do they arrange to review data if we receive medical information 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 (tipsheet)
Promoting Attachment with Your Child While In Country (1 hr. podcast w/ experts)
Surviving the Trip Home With Your Newly Adopted Child (article)

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:

Attachment 101 (1 hr. podcast w/ Dr. Casey Call, of the Karyn Purvis Institute for Child Development)
Typical Behaviors of Children Adopted Internationally (1 hr. online course by CreatingaFamilyEd.org)
Raising Children From Foster Care or Orphanages (1 hr. podcast w/ the late Dr. Karyn Purvis)
Attachment Issues When You Adopt a Child Over Two (1 hr. podcast w/ Deborah Gray)

Ethical is a loaded word. Of course, there are ethical international adoptions, just like some unethical ones. The key to 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 to be raised in a family. It is crucial for adoptive parents to think through the ethics of international adoption in general, 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 (article)
Changes in the Christian Orphan Care Movement (article)
Rescuing the Rooftop Folks: International Adoption Neither Saint Nor Devil (article)
What the Heck is Going On with International Adoptions (article)

One of the responsibilities of parents who adopt internationally is to help their children identify with their birth culture. These resources can help. We have many more, see podcasts & articles below.