What’s Christmas without singing along to the catchy “The Twelve Days of Christmas?” This familiar Christmas carol comes from England where it was first published in 1790. The carol tells the entertaining story of a series of increasingly greater gifts given by “my true love” on each of the twelve days of Christmas. In a case of life imitating art, an adoption story parallels “The Twelve Days of Christmas” with a series of “gifts” which a prospective adoptive parent receives during the process. Let’s unwrap this holiday adoption story.

On the first day of Christmas my true love gave to me…infertility news from the doctor. It was not a partridge, but the news received might be considered for the birds. An adoption story often begins with a couple finding out that their dreams of having biological children will go unfulfilled. Infertility is a common reason people turn to adoption as an option to become parents.

Infertility rates, in general, are higher in North America, and the United States has a high rate. According to infertilityscience.com, infertility is a diagnosis given to women who have been trying to conceive for nine months to a year without success or with one or more miscarriages. This site reports that, as of 2012, six million women between the ages of 15 to 44 in the United States had infertility issues. Statistics from the Centers for Disease Control reveal that approximately 10 in 100 American women have difficulty getting pregnant or staying pregnant. Moreover, 12 to 13 couples out of 100 have trouble becoming pregnant.

Even couples with biological children may experience infertility. Secondary infertility is defined as the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. Understandably, secondary infertility can be surprising and stressful when a couple has successfully had a child or children before. The condition, however, is not uncommon. More than 3 million women in the United States have secondary infertility problems.

On the second day of Christmas my true love gave to me…two options for pursuing adoption. Once a decision has been made to pursue an adoption, the decision-making is not over; it is just getting started. Numerous decisions must be made, often between two options.

The first question is the type of adoption a couple will pursue. Will they look outside the borders of their country for an intercountry placement or will they stay closer to home and adopt domestically?

More domestic adoptions occur than intercountry adoptions. According to the U.S. State Department, there were a total of 4,059 intercountry adoptions in Fiscal Year 2018. There has been a significant decline in the number of intercountry adoptions over recent years. In contrast, domestic adoptions numbered 110,373 in 2014 according to Adoption By The Numbers, produced by Jo Jones, PhD and Paul Placek, PhD.

A variety of factors bear on whether an international or domestic adoption is the best choice. What race of child does the couple desire to adopt? What age child is desired? For infants or very young children, a domestic adoption is the better route to obtain placement of such a child. Is the couple willing to travel or spend time in a foreign country? Can they afford to do so? Are they willing to pursue a placement if family medical history is sketchy or nonexistent—a frequent issue with children adopted from overseas orphanages?

Assuming a domestic adoption is the chosen option, a couple must then decide what type of domestic adoption to pursue. Do they want to adopt from foster care, i.e., from a public agency? Or do they want to pursue a placement from a private agency? Most unrelated placements are handled by public agencies. For example, in 2014, of the total 69,350 unrelated domestic adoptions 47,094 were through public agencies.

On the third day of Christmas my true love gave to me…the opportunity to face the third degree during a home study. In order to adopt an unrelated child, prospective adoptive parents must undergo an extensive background investigation innocuously referred to as a “home study.” The placing entity and the court want assurance that a child placed for adoption will be going into a safe, healthy, and nurturing family. Therefore, screening of the prospective adoptive couple and their home is a prerequisite to having a child placed for adoption. Unfortunately, individuals undergoing this scrutiny commonly feel that it is intrusive.

The specific requirements of a home study may vary according to state law and placing entity requirements. Common components of a home study include a criminal background check, a check of an abuse registry, obtaining personal references, the submission of medical records, a home visit to assess the physical environment in which the child will be placed, a review of finances and employment history, and inquiry into the reasons why adoption is being pursued. Family background and family relationships may also be addressed.

On the fourth day of Christmas my true love gave to me…four inches of paperwork to complete. Adoption is a paper-intensive process. Couples who are adopting will not go through the physical process of carrying and delivering a baby, but they will work for it by having to fill out a stack of forms which may weigh more than the infant they bring home.

To get the home study process rolling, adoptive couples will have to fill out questionnaires, forms, requests for paperwork needed (don’t have a copy of your marriage record or birth certificate handy?), etc. just to get started. The placing entity, an agency or an attorney, will likewise have a stack of paperwork for the hopeful new parents to complete. Some of these requests for information may appear to be (and in fact likely are) redundant, but they are used for different purposes. With all the trees killed to produce sufficient paper for the adoption process, the adoptive couple will hope that there’s a tree out there still standing for use as a Christmas tree during the holidays.

On the fifth day of Christmas my true love gave to me…a five-hour photo shoot to produce pictures to use in a profile book. How does a birth mother select the couple who will adopt her child? Currently, the most popular method of choice is through the use of profile books. Prospective adoptive couples put together, either themselves or with the help of a consultant, a profile book which conveys to a birth mother who they are and what they can provide to her child. These books are filled with pictures of the couple, their home, their pets, their extended family members, their vacation and wedding memories, etc. Profile books also include text which explains to a birth mother why they are pursuing adoption, describes their family life and how holidays are celebrated, and often lists a few of their favorite things such as dessert, color, season, and vacation destination.

Most couples aren’t going to have enough high-quality photos to use to make a profile book. Cue a photo shoot with a professional photographer or with a friend/relative who has a knack for taking good pictures. And getting the amount of pictures needed to fill such a book, often 20 or more pages in length, will require a long photo shoot.

On the sixth day of Christmas my true love gave to me…six possible names to give the baby. Not only is the adoptive couple going to give a bundle of joy a home, but they are also going to have to give him or her an identity, specifically a name. This decision is a big responsibility with huge repercussions. The last name is pretty easy, but the first and middle names are more problematic. Choose the wrong name, and the child may be teased over it. Choose a common name, and the child may feel common. Choose a family name and a family member whose name was not chosen to be bestowed may be offended. Choose an old girlfriend’s name, and the new baby daddy may be in hot water with the new baby mama. Baby books which offer a myriad of names, some of whom no one has ever heard, may make the task even more difficult by overwhelming the couple with choices. And there’s a deadline for the choice. You don’t want to bring home a bouncing bundle of joy and then not familiarly refer to him or her. “Hey, you,” is not a great beginning for bonding.

On the seventh day of Christmas my true love gave to me…seven relatives leaping for joy in anticipation of a new addition to the family. While the adoptive couple may think that the adoptee is their baby, they need to realize that they are adding a member to the entire family. Their parents will be grandparents, their siblings will be aunts or uncles, etc. When do they share the good news of the impending arrival with their family?

This decision may seem like a no-brainer. The first impulse when a match is made is to tell the whole world the good news. But this action may not be such a good idea. Until a consent is signed and deemed irrevocable, this match is at risk. That means that it is possible it will not happen. Will family members be able to handle that outcome? Would you be able to count on them for emotional support if it did or will you have to comfort them? Typically couples inform relatives they are pursuing an adoption, but they may wait to spill the news of an actual match until around the time of birth or even until after the consent is signed. It is a judgment call that depends on the circumstances. Everyone’s relatives are different.

On the eighth day of Christmas my true love gave to me…eight months of waiting to be matched. Placements cannot be guaranteed, and no placing entity has a crystal ball which advises how long it will take for a match to occur. For couples who are eager to start a family, this indefinite waiting period can be stressful and uncomfortable. Would you sit around and wait for the pot on your stove to boil? Of course not. So don’t sit around and just wait for a stork to drop a baby in your lap.

The antidote to sitting around impatiently twiddling your thumbs is to do something. Be proactive. Get the word out to friends, family, coworkers, etc. that you are interested in adopting. You might identify a match situation on your own through personal connections. Work with more than one adoption resource to increase the odds of receiving a placement.

On the ninth day of Christmas my true love gave to me…nine changes in plans for what will happen at the hospital. There is no concrete itinerary for what will happen when the big moment arrives, and the baby decides to make an appearance. All adoptive couples can do is be flexible and prepared to go with the flow. There will certainly be an initial hospital plan, but that plan is subject to change without notice. Sometimes several times.

Due dates are simply estimates as to when a baby will be born. Babies aren’t often born on their due date. The baby will come when the baby decides to make an appearance. The baby does not care when a C-section has been scheduled, what due date has been set, or when it is convenient for you or for the birth mother. You may think the baby will be born on Day A, but then the due date is changed. You may think the C-section will be scheduled for Day B, but then the doctor has an emergency and has to reschedule. You may think birth mother will be induced on Day C, but then there are no beds available for her then. You may think the baby will be born on Day D, but then there’s a health issue requiring an earlier induction or C-section.

The birth mother determines how she wants things to occur at the hospital. Initially, she may want to spend time with the adoptive couple; however, she may feel tired or suffer from complications and may decide not to visit with them. She may say she does not want to spend time with the baby following delivery but then changes her mind and asks for the baby to be brought to her. What happens at the hospital is like General Hospital; you simply have to tune in to find out what is going to happen.

On the tenth day of Christmas my true love gave to me…ten hours of labor by the birth mother. While it is hard for adoptive couples to wait for their new baby, it is also hard for a birth mother to deliver the baby. She must go through labor to give birth. Unfortunately, there is no way to tell exactly how long labor will last, but typically it is measured in hours.

The length of active labor, where contractions are stronger, more regular, and closer together and the cervix fully dilates may be affected by various factors. Women who have previously delivered usually have shorter labors than a first-time mom. Other factors which may have an impact include the baby’s position, the mother’s age, and whether the labor was induced or commenced naturally. No matter how long it takes, the result is the same—a baby eventually appears. The keyword is “eventually,” but the baby will be worth waiting for.

On the eleventh day of Christmas my true love gave to me…eleven explanations by the adoption attorney as to what will happen next. Adoption is a legal process, so the applicable state adoption law governs the procedure and timing of an adoption case. Adoptive couples are focused on their new baby, so previously provided dry explanations of legal requirements are often not retained. Understanding what the steps in the process are, what the timeframes are to accomplish these steps, and what the legal prerequisites are to finalization are important though. Attorneys encourage adoptive couples to ask questions, even if they have been asked before because a grasp of what is happening and why makes the legal journey a bit less daunting and less confusing for the new parents. The only stupid question is the one the couple wants the answer to but doesn’t bother to ask their attorney.

On the twelfth day of Christmas my true love gave to me…twelve days of waiting for ICPC clearance to take the baby home. If the adoptive couple lives in a different state than the one in which the baby was born, the Interstate Compact on the Placement of Children, familiarly known as “ICPC,” applies. Both the sending state (where the baby is) and the receiving state (where the adoptive parents live) must have their ICPC office review a packet of documentation on the adoption to make sure all is in order. It is illegal to take the baby across the state line out of the sending state prior to this clearance having been received.

Obtaining the required approval takes a few days. The clearance process is a consecutive rather than a simultaneous one. The sending state’s ICPC office reviews the packet first; once it clears the packet, the sending state forwards the packet on to the receiving state’s ICPC office for review. Intervening weekends and holidays will slow the process down. If the ICPC office accepts electronic submissions of the packet, time lost for mail or FedEx delivery is eliminated. While it is impossible to provide an exact timeframe to obtain clearance, it is certain that whatever the length is it will seem like forever to the couple waiting to take their new baby home.

Getting through the twelve days of adoption is often an emotional endurance test for prospective adoptive couples. Dealing with the “gifts” these days bring can be challenging and difficult. But the true gift comes at the end of these twelve days: prospective adoptive parents have their own child to love and nurture.