No contact between birth and adoptive families. No identifying information is provided.

Only nonidentifying information (e.g., height, hair color, medical history, etc.) is provided through a third party (e.g., agency or attorney).

Nonidentifying contact is made (via cards, letters, pictures) through a third party (e.g., agency or attorney).

Direct interaction between birth and adoptive families. Identities are known.

• Less grief resolution due to lack of information about the child's well-being.
• May encourage denial of fact that child was born and placed with another family.

• Loss of potential for direct relationship with adoptive family (and/or child).
• Increased grief in the initial years, less later.
• Loss of contact if intermediary changes or leaves (i.e., staff turnover, policy changes, or agency closings).
• Birth mother may feel obligated to place child due to the emotional or financial support given by the prospective adoptive parents.

• Full responsibility for setting relationship limits and boundaries.
• Potential abuse of trust (fewer safeguards).
• Potential disappointment if adoptive family cannot meet all expectations or needs.
• Birth mother may feel obligated to place child due to the emotional or financial support given by the prospective adoptive parents.

• Allows for denial of "adopted family" or fertility status.
• Increased fear, less empathy for birth parents.
• No access to additional medical information about birth family.
• Less control: agency controls information.

• Loss of the full relationship with the birth parents.
• Lack of ability to have questions answered immediately.
• Potentially troubling cards, letters, or pictures.

• Full responsibility for setting relationship limits and boundaries.
• Potential pressure: accept openness or no child.
• Potential difficulty with emotionally disturbed birth parents.
• Potential for supporting both child and birth parents (emotionally).

• Possible adolescent identity confusion (unable to compare physical and emotional traits to their birth families).
• Limited access to information that others take for granted.
• Potential preoccupation with adoption issues.

• Similar to confidential adoptions, if information not shared with the adoptee.
• Potential perception that it is unsafe to interact with birth family directly.

• No clean break for assimilation into family, which some feel is necessary.
• Potential feelings of rejection if contact stops.
• Difficulty explaining the relationship to peers.
• Potential for playing families against each other.