The type of adoption you choose will impact the kind of relationship you and your child will have with members of her birth family. The key to any successful adoption is making sure that your child understands who her primary family is. Children must attach to a primary family, whether that family is biological or adoptive, in order to grow up emotionally healthy. They can love and relate to lots of extended family and friends, but they must have only one main family. At the same time that your child attaches to your family, she can maintain a connection to her birth family.

Current research, including the Minnesota-Texas Adoption Research Project (MTARP) that tracked 190 adoptive families and 169 birth mothers from 1987 to 2000, found that the best results between birth and adoptive families happened when the families negotiated their relationship early in the process, with the help of their agencies. Once the boundaries were established, the adoptive parents managed the contact during early and late childhood, then shifted the responsibility for initiating and maintaining contact to adolescents approaching adulthood. And, finally, adult adoptees continued contact, or not, according to their specific choices.

All adoptions start with a loss by the birth parents, either voluntarily or mandated by the courts, so emotions can run high. Adoptive mothers interviewed for this book describe how hard it was for them to watch the birth mothers struggle and grieve as they signed the papers. Seeing the pain of the women who were responsible for their own joy was difficult to endure. They expressed how hard it was to contain their own joy and how conflicted it felt to know that joy was built on another's pain. Because of this grief, many birth parents decide to go with an open adoption, so they don't lose touch. Sometimes it works and sometimes it doesn't.