[sak9645]

Amy, you have explored many countries by now. I think, by now, that you have learned one thing, which is that international adoption takes a leap of faith.

Yes, giving birth involves a leap of faith, too. But adoption in general, and international adoption in particular, must be considered as having more risks.

Health risks are, in particular, an issue for all internationally adopted children. And when the birthparents are unknown, as they are with most Chinese children, the risks are increased.

With China, you will not know whether there are any diseases in the birthparents' family, which could manifest themselves in your child, sooner or later. For example, you won't know if there is a history of schizophrenia, ovarian cancer, or stroke. Your child could appear to be perfectly healthy now, but could have trouble anywhere from several years from now to when she is older.

With China, you will not know under what conditions your child was born. You will not know whether her birthmother had decent nutrition during pregnancy, drank during pregnancy, got prenatal care, or delivered in a hospital. You will not know the Apgar score. In most cases, problems will be noticeable before referral, and a child with such problems will be listed as having special needs, but as you know from Russia, there are conditions like FAS/FAE that may not show up until a child is of school age.

You will not know, with China, if the child spent any significant period of time with his/her birthparents, whether they were loving or abusive. My daughter was apparently with her birth family for the first 9.5 months of her life, and having observed her over the past nine YEARS, I am convinced that she got her huggy/kissy/smiley nature both genetically and from their loving example during that period. But some families have come to suspect an abusive or neglectful situation.

With China, you will not know, for sure, what conditions in the orphanage or foster family were like. Orphanages and foster care are no substitutes for a permanent family, but some are simply better than others. Orphanages overseas often can't afford to hire the best caregivers, and child abuse is not unknown; foster parents, too, can be abusive or neglectful or only in it for the money. And even when there is no neglect or abuse, a lack of resources and training can mean that children are underfed, given little opportunity for physical activity and socialization, and given little love and intellectual stimulation. Fortunately, children tend to be resilient, but some children WILL come home with problems that need fairly significant therapy, even if they are technically considered healthy.

You will not know, for sure, how well the staff who write up a child's file know that child. Chinese referral documents, these days, are full of statements like, "Loves to eat" and "Loves music." Occasionally, they seem to be pulled from a list, rather than being based on careful observation, although many are very on-target.

And, with China, you will not know for sure if a staffer, acting in what he/she believes to be the best interest of a child, "fudges" his/her health status a bit to get him/her into a good family. The medicals won't be fudged, but a staffer could simply fail to indicate his/her concerns about a child's speech delays or inability to use her left arm well, and a busy doctor may fail to pick up on the problem without such input. There HAVE been occasional children, who were listed as healthy, but who had conditions that should have been clear to the staff and doctors, such as autism.

What I'm trying to say is that you have spent a long time analyzing country after country, without bringing home a child. I know that some of the reasons relate to changes in the countries, and to problems with agencies. But I wonder if you have really searched your heart and come to terms with the leap of faith required for international adoption.

It's a big leap. No one would blame you for having trouble with making it. Many families have turned away from international adoption, and gone to domestic adoption, assisted reproduction, surrogacy, and even child-free living, because they concluded that the risks were too great.

I also wonder if you feel that some countries are simply all-around "better" than others, and if you are searching for an ideal country. If so, I must tell you that there is no ideal country. Risks, not just medical, but also those involved with the process, exist with every country. What matters is choosing among the risks that you will accept.

China is currently stable, but it seems to be moving in the direction of more strict requirements for families, because it is clear that the country can attract married, healthy, young couples to parent its abandoned children. It is also about to implement the Hague Convention, which could cause some process changes.

No one expects the changes to be huge or systemic. But nobody expected huge and systemic changes back in 1996, either, just four years after China passed its adoption law and set up its international adoption process. Yet one month after my dossier went to China, the country announced a huge reorganization of its adoption system! The Ministry of Justice was removed from the process of receiving and reviewing dossiers, and making matches.

I had met the head of the adoption unit at Justice when she visited the U.S., and my dossier was in Justice when the change was announced. A process that was supposed to have been clear cut, and to have resulted in referrals in 2-3 months was totally changed. My adoption actually happened 13 months after my DTC date.

So there are leaps of faith to be made, even on non-medical issues. During my long wait, one couple in my group "jumped ship" and opted for Korea. I was counseled repeatedly to look at Vietnam and other countries. But I had already made the leap of faith that I could deal with the unknowns of abandonment and China's rather sketchy medicals. And I decided that I could deal with the unknown time frame, and with the uncertainties about the way the new CCAA would look at me, an older, single woman.

For me, the risks and the leaps of faith were worth the reward. I have the child of my dreams. But no one can promise you the same happy ending, so you will have to decide for yourself whether you can relinquish control, shut your eyes, and jump -- whether to China, Russia, Armenia, or someplace else.

I continue to wish you the best of luck in finding the child of your dreams.

Sharon