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All I can say is just do your research. Start researching agencies. Get an info packet from EVERY agency you can find, domestic and international. Read up on the different agency policies, find out as much as you can about the different country programs... and ASK QUESTIONS of the agency reps. Don't be shy!
Something that also may help you decide is what kind of child you want. If you only want a certain age, race/ethnic background, or gender, some countries or programs may be "out" because they don't offer children that fit that. If you want a newborn, the US is basically your only choice. If you're more flexible on age, that opens up many other countries.
You also need to do some research on what kind of costs are involved. There are programs out there ranging from less than $10,000 to clear up near $40,000, depending again on what agency and what country you go through.
Also -- what kind of time frame are you looking at with the various countries? I know a bunch of countries have seen major slowdowns lately, so you can't always know what you're getting into, but the agency should be able to give you a general idea.
If you want a fully open adoption, semi-open, or closed will influence your decision as to where to go, as well.
Some countries have age restrictions. You're not too old for any country that I know of, but there may be some out there. Some countries also have restrictions on medical conditions/mental health. Some countries have income requirements. Some have restrictions on the number of kids you already have. Etc. etc.
Whatever kind of situation you're in, and whatever kind of child you want, there are so many different programs that I bet there's several that would work for you. That's one of the good things about adoption being so different from place to place -- almost everyone can find a country or program that will work for them.
Good luck.
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