02/16/2012 12:29 pm ET | Updated Apr 17, 2012

An Adoption Plan With A Happy Ending

As an adoption medicine specialist for more than 20 years, I have read and agonized over the social histories of thousands of children adopted domestically and internationally. These stories are fragments and secrets of a rich fabric of dysfunctional family life from all corners of the world in 196 countries, whether rich or poor, large or small. Most of the time, I have only been given a sliver of what is likely a complex and worthy life of a very young birth mother who may not have ever menstruated or a woman raped and beaten, birthing a precious life all the same.

I am always wondering and yearning to learn more. Sometimes I get the whole story and this is what I want to share today: a very complete story which starts with a very young mother and ends with the adoption of an infant who knew all the players and who will be, in so many ways, defined by the constellation of loving characters in this dramatic narrative.

Even though the vast majority of orphans are relinquished and not abandoned, we have little information about the roots of a child's life. The birth family is ashamed of the pregnancy and makes the decision to relinquish or abandon. There is no invitation from the community to be open and safe and secure. For those poor women who hide their pregnancy and birth, there is danger and desperation. Choosing not to parent one's own child is something that can stalk a mother for the rest of her life. Loss and emptiness from this start of life are rarely managed with gentleness and outreach. Social workers and counselors are not part of this dark moment in the majority of births in extremely poor countries. The birth mother, the new baby and the parents who adopt grieve when there are secrets. There is rarely permission given for contemplation, resolution and healing.

Recently, I received exciting news from a family adopting from Taiwan who I have been working with for about a year. The papers were complete and the child was cleared for adoption. The family had been in Taiwan for three weeks and now they were ready to come home. The baby was referred to the family living in New York about six months ago. This sweet little girl was born to a teenage mother who was 14 during the pregnancy and was 15-year-old at the time of the birth.

The child was placed in an orphanage at birth after the grandparents and unmarried adolescent parent examined the challenges and made the decision not to parent this child, but rather to "make an adoption plan." The child has since been in two foster placements and by the end of the week, she will be living in a permanent home in a transracial family with an older male sibling. During the six months of this child's life, the birth family has been very invested in the child's safety and security; they have visited the child and the child clearly knows this family's faces, their voices, their smell, their style of communication, and their sadness and commitment to her well-being.

The adoptive family spent three weeks living in a foreign city learning about their new little girl. She will be named with her Taiwanese name in addition to an American name that reflects family tradition. They visited with her in their hotel and played with her and fed her and had her overnight. Her six-year-old brother adores her and has become a key focus of the baby's life. This brother is playful and somehow intuitively knows how to charm his baby sister who is a bit reserved and anxious about all the newness around her. New adults of another race are especially suspect after a birth family, orphanage, and two foster care placements. A playful brother who has no expectations is a welcome moment for the baby.

The adoptive family met the foster family and was very assured that their daughter had been cherished. The foster family is an urban family with two parents in their early 40s and their two daughters who attend local schools. This family has had other foster kids over the past 15 years and they are well-trained in the adoption/foster care network of their city.

And the adoptive family has spent time with the birth family. They have had their unofficial "giving and receiving" ceremony. The youngest daughter and aunt, is 12 and the birth mother is now 15. The visit was quiet and thoughtful; the birth mother has held her baby and she has said her goodbyes. There have been photos taken of the grandparents with their daughters and their grandbaby. It was all open and shared and still mysterious because of the language barrier and cultural puzzles.

And I have seen the photos and they tell a story that is inexplicable and important. When I get up in the morning, I look at the photos and agonize over their meaning. They tell the story of what could be if we could change attitudes about unplanned pregnancies and invest in social work and communities... if we could stop laying blame and keep our eyes on the prize which is about permanency.

This little girl can look at the photos and ask questions someday. There will be memories that can be shared with her and there can be satisfaction in knowing that everyone was able to have some closure to a very challenging and impossible moment in life. There was a process and there was support for the families involved. The baby can grow up and even consider going back to learn more about her roots... and meet her foster mother and her birth family.

And the 15-year-old birth mother, who is a good student, will finish high school and has plans to go to college. She is resolved and on her way to healing from a deep loss.

The baby girl is home in New York, eating well, recovered from jet lag, and adapting to her new life.

She was a little cranky and hard-pressed to give up her night bottle and because she slept with her foster mother, she is sleeping with her new "mama." She is giggly and excited at the end of a day when her daddy comes home from work and her brother comes home from kindergarten.

In the vast majority of adoptions, there are stories with only tiny tidbits of a secret life that existed and no social workers to help mothers consider their options. Adoption occurs and there is a new permanent life for the abandoned or relinquished baby, but the cycle of poverty has not been broken for the birth mother who is uneducated and homeless and living in the streets, perhaps... or worse.

I was fortunate enough to be able to visit with the family to see how the little one was faring. We met in the street as I was approaching their home and we stepped into a local café to pick up my hot chocolate and mom's coffee. The baby was in a sling with a hooded sweater covering her sleepy head. Mom pushed the hood back and there she was... a relaxed and secure Asian face, no stress or vigilance apparent. She was snuggling with her "mama" and people in the neighborhood were engaging with her in the shop. The cashier spoke to her in Mandarin and she lit up. It was plain to see that she understood those tones and was happy to hear them. It was a memory sparked and a safe moment. An adoring adult friend threatened to "eat her up." That is so New York... and then we went home and watched her play and enjoy old plastic hair rollers and a salad spinner. Nothing fancy needed at this age. She is curious and sitting up, proud of her achievement to look out at a new level. She is noticeably unperturbed and comfortable; loved and clearly fitting into her new home and family. And her parents were very happy... deliriously appreciative of her presence in their lives.