Marshall and McDonald (2001) noted that there is considerable (emotionally charged) debate around the effects of adoption with, at the extremes, some extravagant claims for and against adoption as a practice. The purpose of this review is not to debate the merits or otherwise of adoption or what the research says about how current adoption practices could be improved. Instead, the focus is on understanding the impact of past adoption practices, and the evidence from the research literature that can be used to assist with understanding and developing appropriate responses to the needs of women affected by past adoption practices.
Many writers (including autobiographical accounts and collections of case studies) either indirectly or directly identify that one of the crucial issues for mothers affected by past adoption practices is for their experiences to be publicly recognised. For example, in her recent edited volume of mothers' perspectives interspersed with documentary material, Cole (2008) quoted the following response from a psychiatrist, Dr Geoff Rickarby. In response to an interview question on his expectations of the NSW inquiry into adoption practices (which reported in 2000), Rickarby stated:
I would have liked to have seen a huge exposure of what was actually done ... you know ... for the adoptees to actually see what a helpless isolated position their mother was in, what drugs were given to them, what coercion, what brainwashing, what illegal things happened and how they were taken from their mothers. (cited in Cole, 2008, p. 173)
This points to a common theme across all of the research: the pervasiveness of the silence and shame, and the impact this has had in terms of isolation, lack of support and specific services. Marshall and McDonald (2001) argued that long-term pain for relinquishing mothers could have been relieved if they had had help in dealing with the relinquishment, accompanied by support and the opportunity to know something about the child (p. 73).
Based on her advocacy work with mothers who have been separated from their babies by adoption, Lindsay (1998) identified some of the needs that she recognised as being part of the healing process (which she sees as a societal responsibility):
•availability of ongoing counselling with highly skilled psychologists;
•provision of trauma counselling services pertaining to mothers and children traumatised by adoption separation;
•establishment of advertising campaigns encouraging mothers to speak out;
•provision of education programs for GPs and other health services providers; and
•avoidance of statements that are likely to re-traumatise (e.g., referring to 'unwanted babies', 'your decision', 'birth mother', 'think about how the adoptive parent feels').
At the conclusion of their groundbreaking Australian empirical study, Winkler and van Keppel (1984) recommended that two things were most needed for these women:
•counselling and support; and
The efficacy of these various services or actions have not been empirically tested in relation to the specific population group; however, they are consistent with the broader theoretical and empirical literature on other forms of trauma, such as the field of child abuse and neglect or adult sexual assault (see Astbury, 2006; Connor & Higgins, 2008). Consideration should also be given to the difference between generalist services, and specialised mental health and other support services for this particular group. As with other groups who have experienced pain and trauma, having society recognise what has occurred (i.e., naming it, and understanding how it occurred and its impact) is an important element in coping with and adjusting to the deep hurt they have experienced.
Winkler, Brown, van Keppel and Blanchard (1988) noted:
Many older adoption practices were cruel and insensitive, reflecting older, harsher social attitudes; the scars left by these practices have never really healed for many people. The probability, therefore, is substantial that adoption-related problems will occur over a person's full life course. (p. 3)
Given that past practices cannot be 'undone', one of the steps in the journey for both mothers and children given up for adoption is the choice around reunion. Given the variability in responses provided in the case study literature, and the absence of any systematic empirical evidence, this is an area where further research would be of particular value. Services attempting to support those affected - including professional counsellors, agencies and support groups - would all benefit from a greater understanding of typical pathways through the reunion process, estimates of the number of reunions that have occurred, the perspectives of those involved, and factors that are associated with positive and negative reunion experiences.
Apart from these issues relating to reunion, the research material—supported strongly by the case studies and autobiographical material (see Appendix, Tables A2 and A3)—points to other ongoing issues for mothers affected by past adoption practices. These issues include:
•personal identity (the concept of 'motherhood' and self-identity as a good mother);
•relationships with others, including husbands/partners, subsequent children, etc.;
•connectedness with others (problematic attachments); and
•ongoing anxiety, depression and trauma.
(note: I added the italics and highlights for emphasis...This study could certainly be applied to First Nations mothers who lost children in North America. The lack of support for us is a further betrayal... Trace)