portaladmin posted on April 17, 2009 16:37
By Michelle Dern, MD FAAP
The decision to adopt a child, whether foreign or domestic, is one that requires careful consideration. The prenatal environment may have a profound influence on the life of the child. Unfortunately, in many cases the details of this critical time are unknown. Pregnancies that result in adoption are often unplanned, and may have a delay in beginning routine prenatal care. The birth mother may have been taking prescribed medications for other conditions which could affect a developing fetus. On the other hand, she may not have been attending to her own health care needs, including not taking prenatal vitamins, not having good nutrition, and not avoiding alcohol, tobacco, and illegal drugs.
Prospective parents in the process of adoption should learn as much as possible about the health and habits of the birth mother. When possible, it is advisable to consult with a pediatrician about the specific risk factors for an individual child based on the prenatal and maternal history.
In cases of foreign adoption, prenatal information is often unknown. In many of the countries which are popular for foreign adoption by Americans, maternal use of alcohol and tobacco is much higher than in the United States. The long term effects of fetal exposure to alcohol may not be known in an individual child for several years after birth. Some children who were exposed to alcohol during pregnancy will have typical facial features, but others may appear normal and have learning and behavioral problems. Infants and children adopted from foreign orphanages are at increased risk for other health problems, including infectious diseases, malnutrition, environmental toxin exposures, and developmental delays. Prospective parents considering these adoptions should consult with a pediatrician with expertise in international adoption. A listing of these specialists is available on the American Academy of Pediatrics website www.aap.org.
Parents considering adoption should ask the following questions:
- Does the birth mother or father have any family history of birth defects, health issues, or learning problems?
- Has the birth mother had previous pregnancies? Were there any complications?
- Has the birth mother taken any medications, including prescription and over-the-counter, before or during the pregnancy?
- Did the birth mother drink alcohol before or during the pregnancy? If so, has she continued to drink alcohol later in pregnancy?
- Did the birth mother use recreational drugs or tobacco before or during the pregnancy?
- When did the birth mother begin prenatal care? Have there been any medical complications?