the hospital experience during the adoption process

Coffee & Conversations: The Hospital Experience with Kathryn Russell

By Jess Nelson, Community Manager, PairTree

April 30, 2024

"Preparing for the hospital experience is one of the most anxiety-provoking tasks for prospective adoptive parents. While there are many generalities of this process, there are also many, many variables that color how this experience will look for you."

The hospital stay is difficult to navigate, to say the least...two families in the same hallway - one celebrating and leaving the hospital with full arms, but one leaving with empty arms to navigate loss and heartache.

Joined by Kathryn Russell, we discussed:

  • The hospital experience - roles, rights, and responsibilities.
  • What is a hospital plan and why it's important (and who should help create it!).
  • Gifting at the hospital - what's appropriate and what isn't.
  • What happens when hospital plans change.

Jess Nelson, Community Manager at PairTree: Excellent. Good morning, everyone, and a happy Friday. We are so excited to have another coffee and conversation session with Kathryn Russell. Kathryn, thank you so much for joining us this morning.

Kathryn Russell, Director of Absolute Love Adoptions: Thanks for having me. I'm excited to chat with you again.

J: Yes, me, too, and for everyone here. My name's Jess. I'm the community manager here at Parry. We are your hub for healthily navigating adoption, and we are so excited to have Katherine here to talk about another very important, but I feel like it's kind of an often overlooked topic and adoption which is the hospital experience.

And, Kathryn, you are a license social worker and the director of Absolute love adoptions where you are just a phenomenal home study provider. But you're also an incredibly fierce advocate for expectant and birth parents.

And again, we're just so excited to have you with us this morning. Do you want to kind of introduce yourself a little bit and tell us about your work with absolute love.

K: Yeah. Well, thanks for joining us, everybody. So my agency is small. We're in Pennsylvania. We're a small nonprofit, and we have really sort of shifted the work that we're doing away from. You know, the basic placement and adoption services to really figure out what was not existing in the adoption space that maybe was a void that we could fill. And when I started really listening and looking, it was the same conversations over and over. So it was a lot of this discussion around birth. Parents not feeling like they were really seen or valued in the experience. And the the feeling that after placement they vanish. They disappeared from the conversation altogether. So a lot of the work that we do really centers around educating families prior to match and placement, and even after but so we can kind of reshape some of these ideas. Figure out where they came from. And kind of help break down those bias or stereotypes that you might have about what adoption looks like expectations. Figure out where you acquire those, break them down, and then rebuild them in a way that is going to be more compassionate, more confident to then move forward into a match and placement.

And we really figured that there's not a lot of these conversations going on yet. These are places where we really should be talking a lot more. I think the way this you know conversation today about the hospital experience, these topics that we're going to talk about that day. That experience is the start of your journey as an adoptive parent, and it's the start of a woman's journey as a birth parent. And so for your child, it's their start where these 2 stories overlap. So really figuring out how to be mindful of all the dynamics happening in the hospital experience. And really engage in this space in a way that's healthy and and confident is really a a place where you can make a lot of growth.

That really does impact how your your then lifelong experience. And the adoption constellation goes. So really important stuff we're talking about today.

What is "The Hospital Experience" during a potential adoption?

J: Yeah. And I think it's so important to kind of keep in mind when we talk about the hospital experience that you're basically 2 separate families and stories in in the same hallway, and at one end you have adopted parents who are leaving with full arms and full hearts, and just full of so much joy. But at the other end of the same hallway you have birth families that are leaving with an empty room, empty arms, and now kind of left to navigate this tremendous loss and grief, and I think that's a really important framework to kind of keep in your mind when you're talking about the hospital experience and and looking at you know what that experience is. Gonna look like for you and your family and your journey.

K: Yeah, I hear people say a lot that it is often the best day in the lives of an adopting parent, and the worst day in the lives of a birth parent, and how those 2 things exist at the same time, and how you kind of create space for that. And and really, I guess, do well in that duality where you can be joyous, but also know that it's a really tough day as well. It's it's complex. And again, not something that there's a lot of how-to guides for, how to do this.

And I think that a lot of what we'll talk about today really just gives people some tools and some experience, so that when they're in this situation they sort of in their mind can be like, okay, I remember talking about this. I knew this was gonna happen, or this could happen, so that then you kind of have some spaces to pull from to to maybe behave in a way that is, is more kind for empathetic, and really does better create and hold that space for everyone to have both joy and sorrow that day.

J: Yes, absolutely. And so today, that's what we're talking about the hospital experience. But, Kathryn, what does that when we say the hospital experience? What does that actually mean? And why is it so important for prospective, adoptive parents to understand that and be prepared for it? Even more even more so than you know, someone who is pregnant and preparing for their own hospital experience as a as they're delivering a child.

K: So I think that in this process we have a lot of focus on educating about the process. And I think there's a lot of conversation around. You know the legal process, and what to get for a baby, and how to how to create the nursery. But there's not a lot of conversation around what to expect this day, and I think it is so essential just to have some frame of reference for what it's gonna look like it's challenging to educate us about because it's gonna look so unique, depending on a lot of variables. So are you traveling to another state that's gonna affect what this looks like? Have you met Mom before? Is dad involved? Have you met Dad before? Are these strangers? Is this a situation where Mom delivered at the hospital and left, and the social worker calls and is trying to find a family. In which case you're not going to meet mom. Is this a situation where you have a great relationship nurtured beforehand. She chose you. You've had video calls together, and so, meeting her at the hospital is something that you've talked about? Are you going to be there for the delivery? Are you staying in the hospital? Are you staying at a hotel. There are so many factors to this that are gonna really impact how this looks.

And so it's hard to educate from a place of here's what to expect. This is what it looks like. So with everything that Justin, I say today, I think it's important just to remember that there will be nuances to your specific experience. That you know we simply just can't, you know, break it each situation down to the minutia of that. But we'll give you some kind of general feelings about what it might look like. So generally speaking, you know, we're we're preparing expectant parents to go to the hospital, have a baby, which is a wild experience. Lots of prep, that they do to have that experience. The prep that you need to do is the adopting family is really internal. I think I think it's a lot of work, for what are my expectations of this scenario that's in front of me? I think the biggest thing for families is recognizing that whatever this looks like

This is not yet your child, and this might be your child, but it also might not be your child, and I recognize that that's a really heavy thing to to know and to have to wrestle with internally. But showing up at at the hospital and walking into the space as though this is your child when Mom has not signed consent, I think, is a huge error. So really, that frame of reference entering into the hospital. Again, whether that's you're going and joining her for delivery, or whether you're going and meeting just the baby, whatever this looks like going in and knowing that until consents are signed, she's an expectant mom. She's a mom. She's not a birth mom, and this is not yet your child. I think that's a huge piece of where we need to kind of focus what we're talking about.

But when we talk about the yeah, when we're talking about the hospital experience, we're really just referring to. Okay, you get the call that she's delivering, and you go. And however long you are in that space, whether it's physically at the hospital waiting to take placement of the child, whether it's at the hospital caring for the child whether it's rooming in with the child, or whether it's simply going to the hospital after Mom has discharged and baby's been discharged and and meeting baby and bringing baby home. So all of those days are what we're referring to as the hospital experience.

What is the Expectant Mom's Birth Plan to help her navigate the Hospital Experience?

J: Yes. So, as we are preparing for the hospital experience, one of the biggest things and one of the most important conversations that I think professionals need to be having with expectant moms is creating a hospital plan, and we know that babies are unpredictable. So sometimes hospital plans are gonna just go completely out the window but also you never know how an expectant mom is going to feel when she's actually in the situation of giving birth, and so keeping in mind that human emotions are going to factor in, and can also completely change a hospital plan.

But what should be included in a hospital plan? What conversations should we be having with expectant moms? So that both expectant moms and adopting families have kind of an expectation of what that experience could potentially look like.

K: So if you're working with an agency and a social worker when we are showing up at the hospital to coordinate a placement, we are typically sending the hospital a a plan, and that hospital plan should include everything we know about the situation. So expectant, mom, expectant dad their information. That mom's due date. The her intentions for naming the child. If she has a name picked out already. We are talking about who the intended family is. We typically list who the family coming to town might be, what their address is, phone number, contact information. So that the hospital is aware of who's we're expecting to see in this in this space. And that, of course, is if Mom has already chosen a family, and there is an intended family.

We also include in this plan things like her care, what she's expecting to happen at the hospital we use as an agency absolute love. Excuse me. We hire a doula for every woman who's delivering with our agency, and I think that is really essential, because what a doula does beforehand is sits with the mom and educates her about what to expect during pregnancy and delivery and what her choices might be. You haven't had a child, biologically, there's a ton of choices that you can make in that space, and I think people generally don't know this stuff.

But there's a lot of choices for how you want to deliver that that you should think about beforehand. And Abdullah is gonna help Mom think about some of those things and figure out what's important for her. And then on this hospital plan, we're gonna include any of that content that she's decided is important. So does she want an epidural.

Who does she want in the room with her? Does she wanna hold the baby? Does she wanna breastfeed? What are the things about her birth experience that she feels are important and that all goes in the hospital plan. Now, obviously, a hospital plan is a plan. It's not a contract.

K: So there's tons of room for things to change. But the idea is that before Mom gets to delivery she's had those conversations with the professional about what birth might look like, and what her choices are, and really figured out what her deep feelings are, and her deep desires for those choices about her body and her child what those are, but then that she's also thought through some of these conversations about, how do we pull adoptive family? In what do you? What does she want this to look like? Does she want them there at delivery? Who does she want to delivery? Where does she want them to be standing at her head, standing at her feet. Waiting in the hallway, waiting in a hotel? So she sort of has to start thinking about what she expects from this process because she sets the tone.

If she says, No, thank you, I don't want them there. Then the family's not going to be there. If she says, yes, I would like them there. Then the family has been invited to be there. But with all of these things she can change her mind.

So she gets to the hospital, and her plan says, yes, I wanted adoptive Mom in the room with me, and she gets there, and you know 2 h into delivery. She's like this just isn't working for me. I need you to leave the room. Then that's just what it is. So this plan is a plan. It's really wanting her to take that time to think through all of the choices after baby's here, who holds baby, who feeds baby, who bathes baby? What do you want those days until discharge to look like so that we've had this conversation.

Now, ideally, this stuff is written down so me as a social worker will have these conversations with Mom.

I'll talk her through a lot of these things. I'll push her to really think about what this could look like for her. Find those spaces where she feels really strongly about something, and then put that on paper. This is so that I know I know how to help that day. I know what her wishes were before all the chaos and intensity and physical challenges of labor and delivery. But also it gives me a point of reference to say, okay, you said this, you know, 3 weeks ago, how are you feeling now? And it helps really guide that conversation. So there is someone there saying, You know, I know you wanted this initially how we feel now. And how can I help you get that.

So in context of families, right? You invited family in for delivery. But now you're feeling like it's too much. How can I help create that space? So you can have this time for yourself. So that's ideally what a hospital plan is. Ideally, the social worker who's working with expected. Mom is having these conversations, and beyond that, if you're matched, that social worker's pulling you into those conversations, so you can say mom and I were talking about naming the baby. And this is something important, because this conversation will happen at the hospital at some point. So here's Mom's feelings on this. Can we talk to you a little bit adopting family about what your feelings are about this?

Things like, okay, mom is thinking about maybe inviting you to the to delivery. Is that something you'd wanna do? So having someone there to really help facilitate those conversations is a massive, massive asset. If you don't have that, or if your social worker hasn't made any initiative to do that. Ask them to. These can be conversations that are hard to have.

Especially if you're putting expectant mom and an adoptive parent in the same space to have those conversations, a lot of raw emotion. There's a lot of you know, that tip toeing around. I don't wanna say something to upset her or make her feel like I'm claiming her baby. But I wanna have these conversations definitely asked to have those conversations and ask to have a social worker there. An attorney. If you're working with an attorney should be able to do that.

You can also as a side note, if you're working with an attorney and you don't have a social worker working with you. Ask that attorney to contract a social worker who is skilled in adoption services to provide these. They, you know, they do these hourly so let's say you're working with an attorney. The attorney would call me and say, KAthryn, can you provide 5 h of support for this family? And then they bill the family at an hourly rate today?

And then what I do is go in, figure out what they need support with. And then I have those conversations. If, again, if you're in a space where you don't have a social worker who is doing that can do that, or you don't have one at all.

J: Yes, absolutely. And I think this might just be my perspective as a birth mom having twice created hospital plans in both very different situations. But I think that initial conversation of what an expected mom wants the hospital plan for the hospital experience to look like. I think that's a really important conversation for her to be able to have with just her social worker or with her caseworker, or with an attorney. Because, like you said, there's a lot of emotions, and I see this so many times.

You know, we've had expectant parents and adoptive parents in the room when we're talking about a hospital plan, and an expected mom will say, yes, I want you in the in the delivery room. Yes, I want you to be the one to name the baby, and then, as soon as the adoptive parents leave, she's like Jess, that's really not what I'm comfortable with. Can we have this conversation again?

And so I think when you give expectant moms that space to really talk about what they want that experience to look like because it's about them. It's not. It's that day, that experience.

It's truly not about adoptive parents, and I know that that's super hard to hear sometimes and wrap your head around. But just from a birth parent's experience, we don't get a lot of one on one alone time with our kiddos. And so, having that experience and having that time in the hospital. Like adoptive parents, you get every other first. That our kiddos have. And so just making sure that you're allowing expectant and birth families to kind of have that space is just really important.

K: Well, I think what we were talking about was the idea that these conversations shouldn't be had for the first time with. So if I'm the social worker. I'm not bringing.

Intended parents together for the first time to say, Hey, Jess, how do you envision your hospital experience going? And it's really, specifically not done like that. I will also tell you. There are so many situations where I'm asking, Jess, hey? How do you envision this going? And she might say, "oh, I don't know. I didn't know I had a say in how this goes." And so, giving her that space to say, Okay, I don't know what are my choices. And then me saying, Okay, I'll call you next week. We'll talk about it next week. It gives her space to hear these things to think about these things, and I guarantee you the women who are being asked in the moment, what do you want? And then put on paper? Those feelings evolve, because then they start thinking. Oh, okay, well, maybe that is how I wanted to do. I wanted to go that way. So we really have to give space to educate. Hey, Jess? Here are some things you should think about.

Do you want the family in the room with you? Do you wanna name the baby. Do you wanna hold the baby, and then revisit and revisit and revisit and reassure her that whatever she says then is not set in stone, and she can change that later. And I think, then bringing family into, say, Okay, just. And I have been talking today, this is what we're thinking. This is kind of how we envision this going. You know she's said that these are the things that are really important to her, but as always, she reserves every right to change her mind that day on anything that we're discussing.

But I think that also gives the adoptive family some sense of okay. What is expected of me. Generally speaking, what does she want from me? Because most families also are really intentional. They want to behave well, they want to show up. Well, they want this to go. Well, not just in the sense that they bring home a baby.

They want to be respectful, and they want to make Mom feel really supported. They often just show up and are like, Okay, nobody's told me what I'm supposed to do here, you know. Does she even want me here? There's no one here to ask, you know. Sometimes there's not a social worker at the hospital who's really skilled, so they're kind of like. I don't know. Should I go to her room? Do I not go to her room? Should I bring her coffee? Do I not bring her coffee. Does she want to see me? Does she not want to see me? So really asking for someone to help...Have these conversations ahead of time will really relieve the pressure for all of you on that day. It also creates that space where you know that you've had these conversations. It's safe to talk about these things. It's not the opposite of this is the situation where families come in. Mom comes in, and they've all had these thoughts the whole time like, well, what is this gonna look like, and what are the expectations for me, and what are what's my choice? What's not my choice?

And nobody's talked about it. So everyone just kind of gets there and continues not talking about it. But if that's what's happening, then you are definitely gonna step on someone's toes. And you're definitely gonna do something offensive. And you are definitely gonna be in a situation as the birth parent where you're not getting your needs met, or you feel like you know, you're swallowing it and swallowing it and swallowing it until you just want to screen, because nobody's seeing what you want. We haven't said what you want. So again, social workers support, and having these conversations before really really really changes the way that whole experience goes.

J: Yeah, and having in like, when you're a professional having those conversations...I think it's super important to remember that your priority is the expectant parent, because when and I will never forget this conversation. When I was making an adoption plan for Ella, I was sitting with the adoption assistant because we did a private adoption. We worked with an attorney, and I was sitting with the adoption assistant writing my hospital plan, and he gets to the question, and he asks who I want in the delivery room, and I said my best friend at the time, and he stops writing, and he like puts his little notepad down, and he looks at me and he goes.

You don't want the adoptive parents in the delivery room with you. And I said, No, he goes well, not even the adoptive mom. I said, no. I was about to be 30 years old. I knew them, but we'd only been talking for a couple of months. I didn't know them all that well, and he goes well, this is a really important day for them. You don't want them to be able to experience this with you. I got up and I walked out, and I was really close to just walking away from my adoption plan in general, because that was...that's a really traumatic day. And to have that lack of support. thankfully, he didn't work there, you know too much longer, but that for someone who was in a different place than I was like. That's really a traumatic conversation to have, and are really bad way to have it.

K: Yeah, I think the way that I typically have the conversations is not oh, you don't want them there, because that then makes you feel like, should I? It? Oh, my gosh! I didn't.

Oh, my gosh! And then you kind of start spinning, thinking. Well, right. It takes this experience that is very much yours and makes it someone else's, which, as the provider and as adopting parents, that's really the the thing we want to protect, we want to protect this experience as the birthing parents, not anybody else's. So I think, having that conversation as here are your options. Some people do this. Some people do that you can do whatever you want. You just tell me what you feel like is right, and that's what we'll do. And that's really the space that birthing families need to be in knowing that ultimately, whatever they want. That's what we'll do. You know, we're guests in their space that day. This is not about anybody else except them.

J: Exactly. And so we have created the hospital plan using the plan very loosely. What happens when that changes?

K: So again, ideally, you're in a space where you have someone at the hospital with you. So, for example, in situations where I'm doing placements. I've hired a doula for Mom. Mom calls and says she's in labor, call the Dula. The duel goes and spends the whole labor and delivery with her. Generally speaking, I try to not be there for that, because that's again her experience. And I'm a professional. So for me, coming in, it's like the cloud of what's ahead for her looming so to preserve that space for her, you know you send the doula, and she delivers, and then I go in. I check on her. I go always go see her first.

We talk about things like, okay. How'd it go? How are you feeling? What do you wanna do you know? Do you want the adoptive family to come? Do you want them not to come? Do you know where? What are we doing right now, and if she says you know, the family's here down the hall, I saw them already, and I really feel uncomfortable with them still being here. Then we'll talk that through, and then I will go to the family and say, Hey, listen! Do you mind? Just, you know, going to the hotel for tonight. I think that's really what she will appreciate most right now, so I can be there to help her.

Her voice, some of these really challenging things. I'll tell you. Most people really have a hard time asserting things that make other people uncomfortable. So if there isn't someone else there to help a nurse who's really I think, empathetic to the situation and experienced with this sometimes can be a really great advocate. Sometimes hospitals have great social workers who do this really well, but by and large, they don't, because there are no training programs for nurses. There are no training programs for any type of provider on how to do this.

Nobody gets adoption training in their programming. So any nurse or professional that you're working with that's doing it well is just doing it, cause she's a kind person, or he's a kind person, and has empathetic feelings towards the situation, or has done it. Enough that they've learned a thing or 2. So, generally speaking, relying on like, okay, we'll go to the hospital, and who's ever there will just help is not.

Don't count on that, because if you get one that does, you're like really, really lucky not to scare you, but just to be very real about what's ahead. So if you're working with an agency who has a representative in town, they very much should be there to help support the hospital experience. So when I do this, I'm there, and I'm sending things back to the office for my team to help me do so. If I'm with Mom. And she says, Okay, you know, I need these things to happen. Someone in the office is doing the paper for placement. And then also being able to change things as we go. So I think, having a person, a live person at the hospital to help mediate these things is critical, because otherwise what happens is, you have 2 people who are really trying to merge, but it's strained at times, just because she's delivered a baby. If you. Sometimes delivery is traumatic, it's long, it's exhausting, it's terrifying. It's joyous. It's this absolutely consuming experience. And you're not necessarily ready 2 h after to make these decisions or have these conversations.

And then, on the other hand, you have a family who's like, I've been waiting for probably years for this moment, and I'm so excited to have these conversations, and I wanna know what she wants from me. And I wanna know how to do this. And so you sometimes have these 2 situations that it's just you gotta find a way to mesh them. And again, there's often not someone there to say, Okay, well, you know. Tell me what you're feeling. Tell me what's going on, and then let me see how I can help. And sometimes that's just running back and forth to rooms, saying, Okay, here's why I think she's ready to do this. Are you okay with that, and I'll let her know. And sometimes it's just sitting with one of the families and just being available, so that when something comes up they can say, Hey, Katherine, can you? Can you check on this? Do you know how she feels about this? Do you know how they feel about this? So I think that is best case scenario. Wanna be real that for many people. You won't have that. You won't have a person to do that.

So I think, as the adopting family, being very aware that it would be great to have a person doing that you don't. So you might have to be the person that thinks about that and says, Okay, I want this. But I don't know what she wants, and I feel really uncomfortable about asking her, but I know I have to, so maybe I'll go pull the nurse in and see if she could help me do this. Maybe I'll ask if there's a social worker here that could help me. Maybe I'll just go and try it and see. And if I make a mess it's okay.

I will just say I'm new at this. I've never done this before, and I want this to be good for everybody. So here's what I'm gonna do.

Birth parents, I think by and large want to be asked what they want. They don't want you making decisions for them. They don't want you to be assuming if in doubt, and you're the only one at the hospital, and you don't have support. Go check on her. Say, hey, Jess, I'm just wondering, you know. I can go get lunch if you'd like some time alone with Baby. I know you said you didn't want that before, but I'd like to go get lunch. Is this a time where maybe you want to spend with your baby. So I think, being proactive, again giving space for her to change her opinion on something, and re-giving that space over and over again. If you don't have that support, it's gonna be down to you to do it, and you'll just have to do it. Sorry.

J: I had this conversation with an adopting family, you know, a month ago at their kiddo's birth. Mom was in the hospital and delivering, and they had this hospital plan all worked out and it changed, you know. The second she got into the hospital. The entire plans change. They were planning on being there, she said, you know. No, I don't really want you here. I want this time, and that can be really really scary, but allowing her that space and giving her that day, or those 2 days or those hours is really really important to her, and she will remember those for the rest of her life. She will cherish those for the rest of her life, and then, when your kiddo grows up, you get to tell them that you know those first 2 days in the hospital. It was just you and your birth, mom, and that's a really special. You know. They're not going to remember it. But that's a really special story. And feeling that they get to have growing up.

K: Yeah. So as you're talking, just one of the things that I'm remembering is a really negative experience I had with a family, and I think I use the word selfish, because that's the closest word. I know how to describe it, but I don't think it was coming from a place of negative intent. I don't think they even realized that what they were doing was really not kind.

And so again I struggle with that word, selfish, but I I think the choices that this family was making in the hospital were entirely egocentric all about them, and I think if you haven't done the work before a match and a placement to look inward. Why am I adopting? Where are the holes in my heart that have led me to this place that I need to fill before I try to make a child fill that space? I think that is really important work. I think that's painful work, because for a lot of families, they've come into this space with again. Often years of really challenging, painful experiences that brought them here, and I've never met a family who's adopting that doesn't very desperately want to. Parent. I mean, this is a really, this takes a lot of work and money and time. And it is heartache to get to this space. So I wanna I wanna put that there. I recognize that I think that when you get to the hospital. It is so essential just to say, I have no control over how this is going to go, and I want to be a good human. And I want this woman and her child to leave this space feeling like this experience was positive and empowering, and they got everything they needed from it. And if that means that I, as the adopting parent, don't, that has to be okay. And I think if you can shift your perspective and show up of in really a place is so painful to say what will be, will be. But you have to, and if you can't do it necessarily fully, internally, which I don't know that you can. I think outwardly you need to be.

As this is not about me as you can, you can do that by recognizing that most of the support of the hospital is going from Mom. It's not going to be there for you. If you're taking care of the baby, you'll have the nursing staff there. You'll have people there to support you. But ultimately Mom needs to be rallied around. She needs to be supported, she needs to be checked in on. So if your worker comes to the hospital and checks on birth, mom, first, before checking on you, it's okay. That's expected. If you feel like, you know, I've paid for this package of services, and I'm getting 10 of the 100 h that this worker is spending, and I don't like it. I'm sorry, but that's how it's gonna be.

And you have to remember that past this past discharge, past consent signing, you get all of the attention. The adopting family gets all the attention you get the worker in your home checking on you. You get the calls, things everything. Okay. You get all of the support then, but you really have to allow that time at the hospital to be hers, and some of the really bad experiences I, as a professional, have had our families who feel entitled to all the attention from the professional wanting, you know, minute to minute updates on. Where are we at with consent? And where are we out paperwork, and what comes next? And when can we leave? And when can we and I get that? These are all things that feel urgent. But on the other end of this is a woman who's making the biggest decision of her life is often alone, I think, more often than not I've supported women who have no one else who are often delivering their first babies, which is again terrifying, and not always what you expect and consuming physically and emotionally in itself.

And then they're doing this choice for adoption. And so they're they're literally just getting through each minute. And that's where I'm needed. So I think that again, if you can really just be aware of what's going on potentially in the other room, it helps you separate yourself to be able to say, Okay, and here, I'm here. If this baby comes home with me because she wants that for me, then yay, and I'm going to do that so well. But if these few days go by and the baby doesn't come home with me, that has to be okay, too. All I can do now is just be here.

Be here, and that's it. And again, I know that's really I don't know that there's any other time in life where we're really expected to do that. And so there's no like. Here's how to do it well, or Oh, I've done this before. So I've got this. It's really unique in that sense. And I also think sometimes people don't know how they're going to behave until they're in the situation. So I think, for adopting parents. Another thing that I'm encouraging you to do in this hospital. Stay is, be very mindful of your own needs.

Because no one else is gonna be looking out for your needs. So things like, I gotta go get some coffee, or you know, I really would love to just go take a walk, go, take a shower, go, take a break and come back. Please do those things.

When we're not fed. When we're not hydrated when we're not sleeping. Well, we're not our best selves. And so those things really need your attention in this in this space. Even if you are the one caring for the baby. During this time one of the things that does happen often in the hospital is expected. Mom, mom then says, Okay, I've delivered baby, and I would like you, the adopting parent, to be here. I want you to room in. I want you to. Often hospitals will set aside a room for the adopting family. That they can then stay overnight in the hospital for the duration of time. The Cha. The child is there, and so they'll then do all of the baby care. And oftentimes moms are okay. With that they'll say that right like this. I'm I've delivered this baby, and I know that you're the parents. And so I would like you to do these things.

And so you get your room. You get to do all the things with the baby, and that does happen sometimes.

Still, be very mindful of your own needs. I know that's really challenging when you're taking care of a newborn in a strange place in the confines of a hospital room. But those are the times where things get heated. Voices get raised things get sad because you are again trying to do this really overwhelming task of staying very neutral in a space where you wanna just, you know, yell with joy and make the process done so you can just leave and be a parent, and I got all of that but that's kind of the the. There's a lot of intensity in those days in the hospital, so doing the best you can to care for yourself, so that you are your best self, I think, is the best piece of advice. If you leave with nothing else, take that video.

J: One last question, and then we will open it up to questions, because you and I have been talking for a long time. But when we're at the hospital and adopted parents are there, are we? Or what's appropriate when it comes to gifts for expected mom in the hospital.

K: Okay. So here's my take on it. If you go to deliver any human in the hospital, I'm sorry. Visit any human after they've delivered.

You bring them something. You always you bring a coffee, you bring candy, you bring a card, you bring flowers that's just sort of in our culture. What you do. It shows that you thought about them before you got there. It shows that you want them to feel special and seen, and you would do this for anyone I mean, honestly, think about who you've ever visited. After a big moment you do this. This is no different.

The space that this is different in is that if you adopt this child and you're in a state where you are not allowed to gift, all gifts have to go through an attorney which I'm in Pennsylvania, and that is a law here. So if I'm to say, go to the hospital with a $200 gift card, that's what Leanne appropriate because the attorney is, I'm gonna say, wait a minute. You've sent this huge gift to her now. And now this looks like coercion. You have brought money to the hospital, and she's not signed consent, and you're trying to adopt her baby. And this is wildly illegal.

So first thing is, make sure you know your State's laws.

Second, when we're talking about gifting, we're not talking about like laptops and $200 gift cards and a a envelope full of money. We're talking about something thoughtful that you would bring at the hospital, and I would challenge you to find an attorney who would say, oh, no, there's no way you can do that. So when you go to the hospital, please bring her something. If you know her, bring her something, you know she would like. If you don't know her well, bring her something generic that would most likely make any woman happy. Honestly, the moms that deliver and the families bring something. It's such a treasure because they feel like you see them not just you see their baby. So some things that I always suggest are anything that's like hospital care like the air so dry, so chastic a water bottle, lotions, anything that can really help her feel like, okay, now, I've delivered this baby, and I just wanna feel like clean and good and fresh. So anything like spa like really is great slippers, a little Blankie. Any, if flowers if she likes flowers, just something. A journal I'm trying to think of all the things I've seen people bring where Mom has been like this.

Her favorite snacks. If she likes magazines. That's a real gift sometimes. Do you figure typically she's delivering. If she's had a smooth delivery. She's going to be there a day, 2 days.

Not a lot to do in a hospital room, so just anything that might just bring her joy. Give her a moment of like. Okay, it's something different from my day. That's a really good intention. We also, as an agency, have created gift boxes for this specific purpose. It's called solace, and one of our gift boxes is full of all kinds of spa things so like a little ceramic dish that you do a little face mask Kit in chap stick lotion just things so that when she's opening this box she's like, yeah, it's a box just for me. The cost that I'm encouraging you to look at is less than $100 is probably appropriate. No gift cards, no money, nothing that can be interpreted as a bribe, but something thoughtful small don't go nuts. That's the suggestion.

Do it definitely, do it right.

J: Yes, absolutely. My birth plan completely went out of the window. I was supposed to deliver in Louisiana, and, long story short, I ended up delivering my daughter while I was on vacation in Michigan. But before that my daughter's adoptive parents have, like reached out to my best friend, and was like, Hey, what is just like to read? What size slippers, what are her favorite snacks? And they had put together this little gift basket to bring me in the hospital.

I didn't get to get it, because life, you know, had different plans, but they still made me a similar type gift basket. When we all got back to Louisiana, and I had gone to the attorney's office to actually sign my consent. I met with the attorney and signed, and they had a gift basket there for me that had, like, you know, a bottle of wine and my favorite snacks, and a new book, and just small, like thoughtful things like that. But it was just really kind and thoughtful and very supportive.

K: Yes, so please do that. Put that in your notes, everybody. That that is absolutely a gesture that is appreciated and encouraged.

J: And if you guys want to check out, I love the solace boxes. I just put the link in the chat. So I encourage you guys to check those out. They are, you know, just incredible. And so thoughtful and almost all local products, which is great. Does anyone have any specific questions about? I know that we've talked a lot, and it's been a ton of information. And I hope you guys have all found it useful. But does anyone have any questions? Feel free to either unmute yourself or drop them in the chat, and we can ask.

Participant: Hey there! So my husband and I are going to be birth parents any day now, hopefully, and one of the things I wanted to make sure that I understood. Is, what are some of the decisions? Again, if we're able to make those decisions and the birth. Mom hasn't that are about the child during their hospital stay that we should consider so like, for instance, like you know, do you have a full name picked out? Are there certain procedures or shots, or something that are traditionally done in the hospital that we would need to just consider.

K: Yes. Great question. Okay, so typically in the hospital in the first couple of days, Mom is making decisions about treatments that she wants during delivery. So there's like an I group that I think it's erythromycin that generally they give babies but that's a choice mom makes whether she's gonna do that or not. It's a a goop on the eye that prevents std spread and so that's something she decides. That's sometimes just a conversation a baby will get a vitamin. KI believe, is the injection that they get shortly after birth, which helps with clotting. That is something that, generally speaking, all babies get, but that is a decision that she'll make. They get information about circumcision. If the child is male. That's a conversation.

They typically do that right away in the hospital. If she consents to that. A. As I'm saying, these these are all things that by law are her decisions to make. She delivers the baby until she signs consents. You have no sign in any of this. If she would like your site in it, or if she says.

I don't care, that's up to the parents to decide, then these are decisions. You should have some feelings about potentially because it could potentially or be your decision to make. However, just so, you know, legally like, if you have this conversation about circumcision, and she says, I don't care. Ask the parents, and you say no, we don't want that. Then she's the one signing the form that says, I decline, not you. It's your wishes, but she signs you can't consent for anything for this child at that point. There is a hepatitis b vaccine that they get at the hospital. There's like a first of 3 doses. So she'd be making a decision about that things that.

Participant: And this is because all these things traditionally come so quick in the process that she has in most states she has not signed off on consent or termination, right.

K: Yes, so like in our state, you can't sign for 72 h. So any decisions that need to be made legally, she has to make. So if she like goes, and there is no one to make decisions. But she is, comes back to sign consents. Then some of these things are then discussed later. So let's say she didn't make a decision about these vaccines, or she didn't decide about circumcision. Well, then, you've then taken custody of the child consents have been signed.

Now you can revisit some of these things. You take your records to your provider and discuss some of these things, and that sometimes happens, too. Sometimes moms just are sort of like froze about making decisions. And so then these might be things you you can decide on. I think there's some other things that during baby care are sometimes choices that in the scheme of things that we think I didn't even know that was a choice I could make. There's a lot of benefit to delaying the first bath in the hospital. A provider will come in and say, Let's do the first bath. So, knowing some things about how the vernix, which is that cheesy stuff that babies are born with is really quite protective for their skin, it's a lot of benefit to delaying that first bath for several days, and instead, just using that that vernex, they rub it in like a moisturizer, and then the baby doesn't need a bath for the first few days.

Those are things that you might want to think about, because if she says No, go ahead. You guys can take care of baby while we're here. It's your baby, you know. You make the decisions. Then you know this informatio and there will be things like, the type of formula that you're gonna use the type of diaper you're gonna use the diaper cream you're gonna use. These are all things, you know. If Mom wants to breastfeed at the hospital and not you not feed baby at the hospital? That's a conversation that you might need to have certainly have these conversations about if Mom starts breastfeeding at the hospital. And this is something that she'd like to continue. How can you support that? Is she? Pumping and freezing and shipping it to you? Are you covering the expense for that? Those are things that you can talk about. Just what else am I missing?

J: I think you've covered just about everything. I will say so since you brought up breastfeeding. If if your kiddos, if expected, mom or birth. Mom decides or says that she wants to breastfeed. Please don't be afraid of that. It does not mean that she is changing her mind, or anything like that sometimes. That's closure for her, or it's, you know, like one last thing that she can do for them. So just I know that I've I've had that conversation with adopting families before, and they have been super terrified when their kiddo's birth. Mom says she wants to breastfeed but you don't have to be afraid of that. It can. It can be really obviously beneficial for the kiddo with all the health benefits of breast milk, but also a really healing experience for her.

K: I also had a a client once who pumped and shipped because for her, she said, I can't raise my child. I can't be the one to do that. But this is something I can do, and I recognize all the benefits of breast milk, and I would like to be able to do that so definitely. Look into that, were there any other things that you thought of when we were talking? That might, you know.

Participant: No worries. That's super helpful. Thank you.

K: Sure, anyone else?

Marquita Moore-Raynor, MK Adoption Services: Hi! I'm Marquita from MK Adoption Services, and I just wanted to say, Thank you, ladies, so much for offering this session everything you shared aligns with what we tell our family. So thank you so much.

J: Absolutely. Thank you.

K: Actually Marquita had posted something recently. Talking about the things that are not your choices in those first few days. And so if you don't follow MK Adoption Services, that's a great account. They talk a lot about. The things that that you can be doing well. I think one of those things that she posted was naming the baby, and while we don't have time here to talk about all of that absolute love at options where I work. We also have a resource about naming the baby, and how you can have some of those conversations, because, again, that is not your choice. I know that for some people you're like, what are you saying? But but that is a conversation that you and Mom should be having together about what her wishes are, because ultimately her choice for name is the first name this child gets, and in in ideal situation should be the name that they keep. So, having some conversations before about how to do that. Well, we have a blog about that. That gives you some very concrete ideas for how to do that. So kind of put that on your list of resources that you can kind of mull over as you move towards batch and placement.

J: Yes. Any other questions?

Participant #2: Hi! I have a quick question. So me and my husband have had free biological children. And now we're going through the adoption process. So I guess, like my mind is, I always want to help the situation. But how appropriate would it be to even try to say like, Okay, like, I've been in hospital before, even though every birthing situation is obviously different. But to almost if I don't wanna help like, should there might be options to help. I don't want to feel like I'm trying to encourage one way or the other, like, does that make sense on like what would be a safe line or conversation, I guess, have around that.

K: So are you talking more like specific things that she might ask or just sort of like general presence at the hospital?

Participant #2: I guess really both just like, I know, like the 3 first I've had have all been different and all been crazy like I I totally know and appreciate every situation is gonna be different. So it's like, I want to push myself forward and like, Oh you know, when I did this. This is what happened, and that kind of thing, but be able to have, I guess, kind of be there if the situation comes up. If that makes sense.

K: Okay. So my suggestion for you is that as a woman who has been through birth, you have really unique perspective on what that can look and feel like. And so I think that gives you a space to relate to Mom, who may not have been in a situation before, or maybe has, and there's a lot of camaraderie, and having shared a pregnancy and shared a delivery experience. And so I think that channeling that a little bit, and showing up in a way that a friend would who says, Hey, I had an experience like this, and this is what it went like or oh, maybe this is something you could try. I think that's very positive. I think you'll have to just be very mindful of you also have this layer of. I'm the person who's on the receiving end of your child, and so that can feel threatening or just challenging in terms of expectant mom's ability to hear that. But I think this goes back to. And just, I'd love to know what you think. This goes back to just having conversations with her, and knowing how she feels about that, I think you can say, Hey, you know I've I've been in this experience before, and I'm open to sharing. If you'd like to know what my experience is that gives her space to say No, thank you, or sure.

J: I also think if it's if she has had other kiddos before, maybe it's not the place to offer your perspective or insight. But I think if she's going through this experience of childbirth as a first time. Mom, then ask if she wants your insight, your perspective. Like Katherine said, give her the space to either accept or say No, thank you.

K: I think sometimes in this experience, too, there's this dynamic of the expectant parent, the birth parent feeling like they sometimes are made to feel like they know nothing. And that the person that's going to adopt their baby is better than them in some way. I think there's often this dynamic of and whether this is like intentionally communicated, or something that's internal for for women. There's often this feeling of I can't do this for my child, and you're the person who's going to be doing it so as as happy as I am that I found you, and I chose you, and you are the person I want to do this.

I also feel a little bit resentful that you're gonna be the person that gets to do this and that I'm not. And so sometimes there's these sort of internal things happening that also contribute to her ability to have you in in her space. Receive your advice and not feel some kind of way about that.

Participant #2: Yes, that makes perfect sense. Thank you.

L: Can I ask you to touch on something, too? I think your talk, by the way, was amazing. So thank you for sharing so much. It was like amazing. My question is, you touched on it a little bit, and I just have experienced this as well in the hospital before on professionals, whether it be a nurse or a social worker that is not adoption friendly and really kind of throws a wrench into things.

How do you suggest if they don't? If a family doesn't have or a mom doesn't have like boots on the ground, somebody actually there to help advocate for them like as a family. How would you suggest or recommend a family help navigate that experience?

K: Yeah, great question, L. So I think that the idea is that you channel your inner social worker as much as you can. And really just. You're a human, and you're a kind human. And you'll see these things happening around you, and you'll have a reaction to it. And I think for a lot of families they'll try to be like, not my place, or I don't know. Maybe this is normal. But ultimately, if you see something going on around you that makes you feel like that doesn't feel good.

Answer that use your voice to say you know what I'm not sure about that. Let's ask mom. So, for example, if this, then this is kind of what these things happen, this is what it looks like. So you're caring for the baby. Let's say, mom is okay with you rooming in for the baby. And she said, Yeah, go ahead and make all the decisions. And then the nurse comes in and she says, Okay, mom and dad, we're let's do the first bath time. I've got all your stuff here. And you're thinking, oh, I know this is special.

I would love to do this, but I don't wanna take this from birth, mom, if she's not ready for me to have this. So I'm gonna say, do you mind coming back in a few minutes? I'd like to go ask Mom if she's comfortable with this first or nurse. Can you please go ask Mom if she's comfortable with me doing the first bath before we make any choices here about that cause. Those are those are things that once done, you can't undo. So I think if you're a a kind human, you're gonna start thinking things like, okay, the first bottle that's huge first outfit that can be huge, taking the footprints. That's huge a person whose birth the child may want to be there for those things. And if I just do this because mom said once, Okay, go ahead and do this. I'm taking these moments. She can't get back. So I'm just gonna say.

I'm not sure. Let's just run this by mom, and maybe you do this a few times. And Mom is like, Oh, my God, Lori, just do it already. Stop asking. Then, you know you've asked. Then you know, she feels really confident about you doing everything.

But I think if if you just really lean into your heart you will see things happening. Other things might be like, maybe the nurse says or does something in front of you. Okay. So sometimes I've been in situations, or we're all in a room together, and we're just sharing space.

And nurse comes in and she wants to know something about the child or the plan, and she looks at the adoptive parents and asks, she'll say, Well, what what are we doing for the first bath?

And instantly you're like, Oh, gosh! I don't know. what do I do? So channel that obviously makes you uncomfortable. It probably made her phone uncomfortable, too. So say, I don't know. Let's ask mom. just embracing this idea that you're just there. You're kind of like furniture for this experience, and you're just gonna kick it all back to Mom until you feel like she's either asserted. Stop kicking it back to me. I'm good. Or she said, Yeah, you know what I would really love to do all this stuff. So yeah, I'm gonna take all this. So I think, L, if that answers your question, I hope. But I think just being really proactive about using your own heart and your own instinct because it's there. It's just, I think, often clouded by a lot of the do this. Don't do that. That adoptive parents get around this experience, and I think they sometimes feel like it's so hard to make the right choice, because I don't want to do it wrong, and there's no one here to support me or this person said that, or this person said that quiet the noise. Go with your heart, because more often than not that's that's where you need to be.

L: Yeah, no, thank you.

J: I think we have time for one last question. Does anyone have one last question they wanted to ask. If not, that's okay. No pressure.

K: We love questions.

L: I'll ask one last question. If no one else is going to. How do you do you have any suggestions also? Just so like this. The conversation is prepared for everything about when child protective services gets involved at the hospital. If that ever is something that's happening like how to address that as an adoptive parent, or if you have any say, or involvement, or anything like that.

K: So typically, if child protective services is getting involved, there is nothing that you, as the family, can do other than continue to be kind and empathetic. Really, if that happens, there is, your agency needs to be the one taking care of the logistics on all of that most of the time. If this was a planned adoption and Cps shows up. It's as simple as this. Mom's already made an adoption plan. So this child care is not.

They're not in danger. And it's really just like a formality of making sure that this child's cared for in some states. There are laws about, you know, if mom test positive for certain substances, or if baby does, then someone needs to be called. Sometimes it's just protocol, other times that might be a mom that has had involvement with during pregnancy. Maybe no one was aware of it, and they're doing their job to make sure that this loop is closed.

Sometimes that can feel really scary. But really, all you can do is say, yes, we're here we are. We were chosen as the parents for this child, and we are fully prepared to take this child. And then, just, you know, be furniture, and let your agency care for it. I think you can also check in with Mom and just reassure her that you're still there.

J: Great question, Laurie.

L: I love your furniture. Comment. By the way, that's like amazing. I call it a leaf blowing on the tree, but I like furniture.

J: Well, I think that's all the time we have for this morning. Thank you so much, Catherine. It is always just an absolute joy to talk to you and learn from you, and thank you everyone for joining us. I know if you're on the West Coast. It was bright and early for you this morning. But if you want to find Catherine, you can find her over at absolute love. And we will hopefully have Catherine back again.

K: Yeah, I love this a lot. So thanks everyone for being here. I love talking about this stuff. If you have other questions or thoughts feel free to send me a message. Send me an email. I'm happy to to help you explore some of these conversations.

Jess Nelson Jess Nelson is the Community Manager at PairTree, focused on growing the resources, programs and education offered for both expectant and birth families, and adoptive families. Jess has spent the last 5 years working in the field of private adoption, first as a paralegal for an Adoption Attorney in Louisiana and most recently with PairTree. As a birth mom of two through private adoption, her firsthand experience of both agency and attorney adoption led her to becoming an adoption professional and join the fight for reform and post placement care for birth moms.

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