The purpose of this quantitative research project was to examine what services birthparents identified as needed prior to the adoption and post-adoption, what mental health issues and symptoms they are facing, and what the impact of adoption is on birthparents. Data were gathered through an online quantitative survey that relied on a convenient, purposive, and snowball sampling. The surveys were distributed through various birthparent support group websites, and Facebook pages and groups. Results of the research showed that participants that placed a child for adoption prior to 1990 had less access to services than those participants whose adoption occurred after 1990. However, participants in both year groups valued and wanted therapy/counseling, case management services, and support groups equally. The most common mental health symptoms among participants were depression and generalized anxiety and the majority of participants felt that their adoption experience contributed to their mental health symptoms. With this comprehensive understanding, adoption professionals can tailor pre and post-adoption services to meet the unique mental health needs of birthparents.

Over the past twelve years, Philadelphia has undergone an unparalleled large scale shift in the way maternity care is provided, accessed, and considered. Key aspects of the changes to the landscape of birth in Philadelphia include: the closure of the majority of hospital-based maternity units, the activities of local women's health non-governmental organizations (NGOs), and the new set of pregnancy care and birth choices that parents navigate. One of the most striking results of the restructuring of Philadelphia's maternity care system is a drastic reduction in the number of hospitals with maternity units. While the birth rate in Philadelphia has remained consistent around 22,000 per year, since 1997 two-thirds of the hospitals in Philadelphia have eliminated their maternity services. During this time, numerous local women's health-oriented NGOs worked to established themselves in Philadelphia. The aim of each NGO has been to respond to inadequacies in the provision of maternity services that develop as hospitals, the dominant resource for maternity care, withdraw from the maternity care business. With only six hospital maternity units remaining and a couple of local nonprofit organizations attempting to supplement the dearth of services, the current system within which parents and health care providers maneuver is both unstable and inadequate for meeting the maternity care needs of the community. In this research project, I explore the processes through which this new maternity care system is being established in Philadelphia with a particular focus on the influence of neoliberalism as an active force in the restructuring process. I examine the outcomes of this restructured system in terms of how lived experiences are influenced by the social, political, and economic reconfiguration of birth. The case of Philadelphia is of particular value as the City's maternity care system has undergone an accelerated restructuring that is unmatched in other areas of the US. While a similar trend in restructuring can now be found in other locations, these changes happened earlier and have continued in a more extreme manner in Philadelphia, marking Philadelphia as a possible canary in a coal mine. Understanding the outcomes of this large scale change in the system of care provides a basis for contending with similar trends elsewhere. My ethnographic work focuses on the experiences of particular individuals as they navigate Philadelphia's new system of maternity care. Within this restructured system of maternity care, the interests of parents and health care practitioners are increasingly devalued or disregarded, particularly for those whose philosophy of birth differs from dominant biomedical maternity care practices. Midwives, whose non-interventionalist methods of care starkly contrast with the biomedical model of care, and parents who wish to have a low-intervention or natural childbirth struggle to achieve their goals within the confines of Philadelphia's maternity care system. Similarly, individuals running local NGOs strain to intervene in the process of restructuring, and often face the dilemma of remaining true to their mission on one hand or preserving financial security by meeting the imperatives of funders on the other hand. Therefore, I have made the stories of midwives and parents seeking alternatives to biomedical care central to my analysis in addition to conducting in-depth fieldwork with three local women's health-oriented NGOs. This project adds to our understanding of how broad political and economic trends in health care translate into select cultural formations which inform the life choices of individuals. In times such as now, when national policy regarding the provision of health care is under scrutiny, it is essential to connect the dots between the circumstances of individuals and the structure of systems of health care. This research project fuses analyses of civil society institutions, the politics of reproduction, national ideology, and local political and economic agenda to present a complex and inclusive assessment of the landscape of birth in the uniquely positioned city of Philadelphia. / Anthropology

This dissertation describes a study that investigated the perceptions of foster parents and kinship caregivers (grandparents caring for their grandchildren) around contact issues between children in their care and their birth parents in Canterbury, New Zealand. The study employed a qualitative approach for data collection and analysis. The qualitative method of data collection for the study comprised of three focus groups, two with foster parents and one with grandparents. The focus groups were conducted using a modified Nominal Group Technique (NGT) where two questions posed to the participants sought to understand their views about behaviours they noticed in children in their care before and after contact with birth parents. In addition, a further question was asked to gain an understanding around their feelings on contact with birth parents. Findings of the study indicated that foster parents largely described children’s behaviour before and after contact to be distressing and stressful for them, with few positive benefits. Furthermore, foster parents mainly stated strong, negative feelings around contact with biological parents. In the discussion, implications of these results are discussed for foster children, foster parents and social welfare practices.

The aim of this thesis is to try to understand the experiences of Swedish-born adoptees during the process of searching for and meeting their biological family. The subjects have been recruited from the Organisation of Adult Adoptees and Foster Children (AFO) and some other sources. The group consists of 20 adult Swedish-born adoptees, ten women and ten men.   Data have been collected through questionnaires with both open-ended and closed questions regarding their childhood and through interviews with structured questions and follow-up questions concerning the search process. The elaboration of data bas followed the search process and highlighted common features, which have brought about certain themes. The analysis of the descriptions has been made according to some existential key concepts in order to deepen the understanding of the search process. Thus, some broadly human existential dilemmas have emerged.  The results indicate a heterogeneous group of subjects. One salient feature is that the search process has been activated in critical situations when lack of knowledge about identity and heredity has been experienced. Another distinct result is the need to get physical likeness confirmed when meeting biological relatives. Such an experience has met a deficiency. Yet another distinct result is the need of contact, no matter the quality, with biological relatives so as to experience closeness built on biological bonds. There has been a will to establish lasting relationships in order to experience identity and continuity. Furthermore, many have experienced during the search process that getting a biological family has added a new dimension to their lives and contributed to personal healing. The adoptees' search for their origin can be seen as a process where broadly human existential dilemmas are particularly prominent.

Adoptive parents need to be able to reflect on the interaction with the child, both from the perspective of their own relational experience with the child and from the perspective of the previous experience of the child. This essay explores five adoptive parent´s thoughts and feelings about their children’s background. It also looks into how they think that the children’s background influences their way of expressing their needs and how this makes the parents feel. Data has been collected through semi-structured interviews which have been analyzed using thematic analysis. The thoughts and feelings around the children’s background mainly concerns how the children were taken care of prior to the adoption and the birth parents. The parents expressed feelings of sadness and sorrow regarding how the children were taken care of prior to the adoption. Thinking of how it could have been for the children gave rise to strong emotions. The parents expressed sympathy and sorrow but also rivalry, envy and anger towards the birth parents. They describe different behaviors’ and expressions that the children have and how they think that these may be related to the experiences the children had prior to the adoption. The parents describe what the children’s behaviors and expressions arouse within themselves. They tell about strong somatic and dissociative reactions, feelings of guilt, uncertainty and insufficiency. The parents also describe how the interaction with their children reminds them of painful experiences from their own childhood. The accounts show the importance of the parents´ ability to mentalise and how they think about needs that the children don´t express.

The Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption was agreed upon in 1993 at the Hague Conference on Private International Law to address growing allegations of abduction, sale, and trafficking of children around the world. The Hague Convention guides countries to attend to the “best interest of the child” in making decisions on intercountry adoptions, and to apply the “principle of subsidiarity,” which calls for the consideration of family and kinship placement and national adoption prior to the consideration of intercountry adoption. This dissertation research focused on the experience of Guatemalan mothers reporting the abduction of their children for intercountry adoption. It examines implications for human rights and the child welfare system. In countries where child abduction allegations have been widespread, illegal adoption has been found to be a common practice and is the result of international child trafficking. Large financial gains are implicated in this type of organized crime, which appears to promote baby selling. In countries enacting the Hague Convention, the continuation of these allegations points to the governments’ inability to prosecute and penalize those responsible. Illegal adoptions pose significant threats to the ethical standards set by the Central Authorities established to implement the Hague Convention. Child abduction has been found to complicate and delay the determination of adoptability, and to undermine due process for legitimate intercountry adoptions. Child abduction has profound effects on grieving mothers and their families after the loss of their children with no resolution in sight. This constructivist research documents the story of three Guatemalan women who reported to public authorities the separate and unrelated abduction of their respective daughters in 2006. The case study report is a “thick description” of the lived experience of these mothers before, during, and after the child theft. The narration comprises an interpretation of their experience, or the participants’ meaning-making of such experience. Based on the mothers’ accounts, their victimization at the hands of child traffickers was followed by victimization by public authorities, who did not exercise due diligence in these child abduction cases. After these survivors exhausted their individual searches for their children, they approached the Fundación Sobrevivientes, who provided them with legal representation and psychosocial support. Together with other mothers, these women publicly advocated for their rights and the rights of their children. Their collective response to this form of violence was critical to accessing the case files in which they identified their abducted children. By engaging in individual legal claims, the participating mothers have sought nullification of each intercountry adoption and the prosecution of those involved in the corresponding illegal and corrupt activities. To conduct this constructivist inquiry, the researcher spent a year in Guatemala, completing prior ethnography for the emerging design and carrying out the interviews. This involved engaging participants with the researcher in a “dialectic hermeneutic process” through multiple “waves” of interviews (at the personal, practice, and policy levels), concluding with two phases of “member checking” or participants’ review of the research findings. To enhance rigor, besides analyzing the relevant literature, the process involved peer and translation reviewers and consultations with national and international scholars with relevant knowledge and expertise, including dissertation committee members. The four elements of the working definition of child abduction developed from the literature review (child theft, deceptive, coercion, and fraud) and other hypothesis on child abduction were confirmed in the mothers’ stories and by the research participants. The tentative findings or lessons identified in this constructivist inquiry should not be considered generalizable, but as “joint constructions” or co-creations between the research participants and the researcher. Based on general guidelines, the readers are encouraged to make their own assessment of the case report, and decide on whether the findings are relevant or may be replicable in other contexts.

Text in Afrikaans / Summaries in English and Afrikaans / Narratiewe navors:ing is gedoen om vas te stel watter rol geloof speel in die aanneemgesin. Onderhoudvoering met aanneemouers het die kernfaktor in die funksionering van die gesin as die aanvaarding of verwerping van die verskil tussen gesinne wat deur aanneming saamgestel is en gesinne wat deur geboorte saamgestel is, uitgewys. V erwerping strem verhoudinge binne die gesin, maak die gesin kwesbaar vir stres en vervreemding tussen ouer en kind. Aanvaarding, aan die antler kant, beteken dat die ouer die behoefte van sy kind om met sy natuurlike ouers in aanrak:ing te kom, erken. So 'n houding bring 'n verbetering in die ouer-kindverhouding mee en gevolglik ook in die vennoe om ontwikkelingskrisisse te hanteer. Geloofkan 'n rol speel om an.gs en selftwyfel by die aanneemouers as gevolg van die onnatuurlike samestelling van die gesin te besweer, sodat hulle die verskil aanvaar en sodoende 'n gesonder perspektief op gesinwees ontwikkel. / Narrative research was done in order to establish the role of faith in the adoptive family. In interviews with adoptive parents it was found that the crucial factor in the functioning of the family is the acceptance or rejection of the differences between families created by adoption and those created by childbirth. Rejection hampers relationships within the family and renders it vulnerable to stress and enstrangement between parent and child. Acceptance on the other hand means that the parent recognises the need of the child to connect with his birth parents. This latter attitude results in improved relationships between parent and child and in more effectiveness in coping with developmental crises. Faith can play a role to cl.ispell the anxciety and self-doubt of adoptive parents resulting from the unnatural constitution of their family, accept the differences and in that way may contribute to a healthier perspective on the family. / Philosophy, Practical & Systematic Theology / M.Th.(Pastoral Theraphy)

Text in Afrikaans / Summaries in English and Afrikaans / Narratiewe navors:ing is gedoen om vas te stel watter rol geloof speel in die aanneemgesin. Onderhoudvoering met aanneemouers het die kernfaktor in die funksionering van die gesin as die aanvaarding of verwerping van die verskil tussen gesinne wat deur aanneming saamgestel is en gesinne wat deur geboorte saamgestel is, uitgewys. V erwerping strem verhoudinge binne die gesin, maak die gesin kwesbaar vir stres en vervreemding tussen ouer en kind. Aanvaarding, aan die antler kant, beteken dat die ouer die behoefte van sy kind om met sy natuurlike ouers in aanrak:ing te kom, erken. So 'n houding bring 'n verbetering in die ouer-kindverhouding mee en gevolglik ook in die vennoe om ontwikkelingskrisisse te hanteer. Geloofkan 'n rol speel om an.gs en selftwyfel by die aanneemouers as gevolg van die onnatuurlike samestelling van die gesin te besweer, sodat hulle die verskil aanvaar en sodoende 'n gesonder perspektief op gesinwees ontwikkel. / Narrative research was done in order to establish the role of faith in the adoptive family. In interviews with adoptive parents it was found that the crucial factor in the functioning of the family is the acceptance or rejection of the differences between families created by adoption and those created by childbirth. Rejection hampers relationships within the family and renders it vulnerable to stress and enstrangement between parent and child. Acceptance on the other hand means that the parent recognises the need of the child to connect with his birth parents. This latter attitude results in improved relationships between parent and child and in more effectiveness in coping with developmental crises. Faith can play a role to cl.ispell the anxciety and self-doubt of adoptive parents resulting from the unnatural constitution of their family, accept the differences and in that way may contribute to a healthier perspective on the family. / Philosophy, Practical and Systematic Theology / M.Th.(Pastoral Theraphy)