By Nina Anderson, LCSW

Placing a child for adoption is a deeply emotional and life-altering experience for birth parents. While their reasons for choosing adoption may differ, comprehensive mental health support is essential in helping birth parents process the complex emotions involved. While we have made progress in adoption-related mental health services, the focus remains mainly on adopted individuals and adoptive parents, often neglecting the need for therapeutic support for birth parents. Expanding mental health resources for birth parents is crucial to ensuring their emotional well-being, both immediately after placement and in the long term.

The psychological stress of an unplanned pregnancy—combined with the pressure to make a permanent, lifelong decision in a short time—can be overwhelming. After placement, birth parents often endure profound grief and loss, along with Post Traumatic Stress Disorder, Anxiety, and Depression. They also face the challenging task of integrating their new identity and role as a birth parent, both internally and in relation to others. Each birth parent approaches the adoption process with unique personal circumstances, histories, and family dynamics, which may influence the healing they need after placement. Recognizing that birth parents are not a monolithic group, it is essential to address their individual needs with the support of a trained adoption and birth parent competent therapist who understands the complexities of their experience.

While each person grieves differently, the post-placement period is often endured with little or no support. It is essential to help birth parents understand that grief is a natural part of their journey and does not necessarily have to conflict with other feelings, including if they feel that their decision was best for them and their child. Encouraging birth parents to recognize that their feelings are valid—and that fully experiencing and honoring these emotions is a necessary step toward healing—can help them navigate the stages of grief. 

A birth parent’s grief extends beyond the immediate pain of separation from their child. The losses they experience are often complex and multifaceted. In addition to the physical loss of their child, birth parents may grieve the loss of their role as a mother or father—both in the present and the future—the loss of community and family support, the loss of relationships, the loss experienced by the child’s siblings, and the loss of self-esteem and societal value. 

Unfortunately, many in society still cling to the outdated belief that a birth parent should simply "move on," failing to recognize the depth and complexity of their experience. This lack of understanding only adds to the emotional burden they carry. It can lead birth parents to experience disenfranchised grief, a type of grief that can occur when a loss is not socially validated, openly acknowledged, or publicly recognized. This lack of acknowledgment often leaves birth parents feeling isolated and without adequate support. Without the ability to grieve openly, navigating the stages of grief becomes more challenging, increasing the likelihood of developing complicated or prolonged grief.

Trauma is often a significant component in a birth parent’s experience. A crisis pregnancy, the adoption placement, and the separation from their child can each be traumatic events or may serve to trigger prior traumas. For some women, their pregnancy may be the result of an assault or incest, while others may have experienced a traumatic delivery. Although trauma and grief share some overlapping symptoms, a trained therapist needs to differentiate between the two, as they require distinct approaches to healing. 

Ensuring that birth parents have access to appropriate therapy is vital for their well-being and personal growth. A qualified therapist can assist a birth parent to understand their experience better, normalize their feelings, and offer support in navigating their immediate needs. Cognitive Behavioral Therapy (CBT) can assist birth parents in identifying and changing negative thought patterns and beliefs about themselves, and fostering improved self-esteem. Dialectical Behavioral Therapy (DBT), on the other hand, can help to develop stronger coping and emotional regulation skills while reducing self-destructive behaviors. Therapy can also provide a safe space for birth parents to explore and process conflicting or ambiguous feelings, such as shame and guilt, and to gain a deeper understanding of how their past experiences shaped their current circumstances. Therapists can also provide evaluation of other mental health needs as well as collaborate with doctors for screening and treatment of postpartum depression and anxiety. Postpartum mental health needs are often missed due to a lack of follow-up or by the assumption that the birth parent is only grieving and, therefore, dismissing other postpartum symptoms.

Therapy can also support birth parents in developing appropriate support systems, navigating relationships with family and friends, and creating realistic goals to equip them with the tools needed to take the following steps in their lives. Many birth parents have concerns about their future roles as parents and need support with explaining the adoption to the children that they are parenting. Addressing their emotions surrounding open adoption, as well as guiding them in building healthy relationships with both their child and the adoptive parents, is an integral aspect of the therapeutic process.  

For each adopted child, there is a birth parent who deserves recognition and support. Sadly, our community of birth parents continues to be overlooked, and we must become proactive. As a community, we need to continue to train therapists in this area, advocate to agencies and attorneys to prioritize mental health treatment for birth parents and pursue changes in legislation to ensure resources are available and accessible to birth parents. Helping a birth parent heal by providing mental health services is not only ethical and should be considered best practice, but is also an investment in the birth parent’s future and the well-being of all who are touched by adoption.