ADOPTION AFTER CANCER: INTERNATIONAL ADOPTION
A little while ago I kicked off a new blog series with a social worker and to-be adoptive mama friend, Nikki.
We kicked off our first post – Adoption After Cancer: What Are My Options?
Today, we introduce our second post and talk specifically about international adoption. If you have ANY questions, leave us a comment or visit Nikki’s blog to get in touch with her directly!
INTERNATIONAL ADOPTION + CANCER
Questions answered by Nikki DeSimone Pauls, MSW – September 2013
1. Can I adopt from ANY country if I’ve had cancer? If not, which countries are closed to me?
Countries open for cancer survivor adoptions depend on the type of cancer, length of time since the patient has been in remission, and again, that all important doctor letter. (See our first blog post.) The only country that was giving a firm “NO” to cancer survivors was Russia, but that’s not even an option for anyone now.
2. Are there any countries that cancer survivors have an “easier” time adopting from? What are some good options?
There are some countries that perhaps would be considered “easier” in terms of cancer survivors adopting. This includes most of the African countries and Haiti that generally have less stringent requirements of adoptive parents in general. However, if interested in adopting a special focus (aka. hard to place) child from China, agencies are having some success in getting “waivers” for their clients for all kinds of things, past history of cancer included. Colombia also has been pretty good in giving approval to families with a cancer history who have a favorable doctor letter. I think Russia would have been the only country that would have been too big of a challenge.
3. Is my wait time extended in international adoption because of my cancer history?
Absolutely not. If you are approved for adoption, regardless of your past history, you are now in the waiting line just like everyone else. Most international adoptions are pretty organized and the countries process applications in the order they are received, so they are just processing one after the next, not skipping over people due to health history or background.
4. What kind of physicals are needed to adopt?
This depends on what country you are adopting from. Some are pretty easy, such as Ethiopia, that is just a quick letter from the doctor that says “I have examined (name) and find her/him to be in good health and free of communicable diseases.” Some other countries, such as China, have more significant forms where doctors fill in blanks about health history, current issues, medications, and require tests for HIV and TB. Any cancer survivor should expect to prepare an additional letter from his/her oncologist about the cancer, treatment, length of time in remission, and likelihood of recurrence.
5. What types of documentation do I need to provide to internationally adopt as a cancer survivor?
You will have to comply with the medical form or letter as required by the country, and then will also need to provide a supplemental medical letter, as summarized in our last post about adoption after cancer.
6. Would you recommend me look into international vs. domestic — or does cancer history impact that at all?
This comes down to where you feel more of a connection. It’s nice that we have a choice in this day and age on where and how we can complete an adoption and a cancer history does not prevent a person from one or the other.
7. Do cancer survivors have an “easier” time adopting one method over another?
I would say that perhaps domestic adoption would be “easier” for folks with a history of cancer because they are being chosen by the birth parents. An individual with a cancer history adopting internationally might have to gather more medical letters or documents to present to the country for approval, or get a medical waiver, whereas, if a birth parent domestically choses the family, she/he may not be concerned about the health history. All this to say, I certainly would not rule out international adoption, it just may result in more hoops to jump through.
8. Do other countries understand cancer like the U.S.? Anything we can do in a home study to help the process go smoother?
I think with medical advancements in other countries, we are all starting to understand cancer better. However, there are some developing nations that still do not understand quite as well as we would like. It is through people adopting from these countries that we can advocate for our cancer survivors and teach these countries the great medical advancements and successes we have in 2013!
9. Does it cost more to adopt internationally if I’ve had cancer?
Absolutely not! When you begin an adoption process, your agency should provide you with a fee agreement and nothing should deviate from that. The only potential additional cost to a cancer survivor would be if you have a doctor who charges you $25 or $50 to write this supplemental letter. Some doctors offices charge extra for letters or paperwork processing. But, regardless, you will not be paying extra money to the agency or country due to your health history.
10. What if my cancer returns when I’m in the middle of an international adoption? What if I’m doing post-placements?
This is a tricker question and has three variables.
1) If the cancer occurs again while you are waiting for the adoption, my advice would be to put your status on hold and focus 100% on your treatment. If you are a cancer survivor and reading this, you understand better than I do how important it is to keep your “head in the game” with your treatment. Focus on getting rest, eating right, keeping your strength up, praying and giving what you can to your work and your families. To put an adoption in the middle of that…I would say that’s the variable that can wait and the responsible thing for everyone involved is for you to put your application on hold.
2) If you are in the post-adoption phase of your journey, God bless you! You are then running around after a toddler, trying to bond with your new child, in between chemo, getting drained and trying to get some rest. Bless your heart. Your mom or best friend is going to be more helpful in this time than your social worker will be! But seriously, other than you dealing with your health and crazy life situation, your adoption should not be affected as it has been finalized and that child now is just like a biological child.
3) If you are in the post-placement phase of your journey (meaning the adoption has not yet been finalized) I can’t venture a guess how the judge or commissioner in your municipality would handle this. This is going to be a question for your legal counsel. I once went to court for an adoption finalization with a family who disclosed, under oath, in court that the reason the mom didn’t travel to adopt the child is because she found out about her breast cancer about eight weeks before she was set to get on a plane to adopt internationally. Her husband went by himself and she blamed her staying home on her hectic work schedule. I believe the perfect “0” my mouth made for a solid 30 seconds showed the judge my complete and legitimate surprise when the mom made this disclosure during the hearing! The judge approved the adoption, but he was not happy. However, he felt that removing the child would do more harm to the child who had been in this couple’s home for six months. Which, is absolutely true and of course, agreed. So that’s just one example, but certainly not exhaustive of all the possibilities. Consulting your attorney is going to be key if this situation presents itself.
11. Are there any groups or agencies that are “cancer survivor friendly” in regards to international adoption?
Again, for most international adoptions, getting a waiver is going to be necessary. When you are researching agencies, ask them their thoughts about how likely it would be that they could get you a waiver. Most ethical and compassionate agencies will process this for you before you have even applied with them or paid a penny. It is a fine request for you to ask this of them before you start paying.
12. Why do some groups have a waiting limit on how far into remission cancer survivors must be before they can apply?
I think that’s to do with our thoughts as social workers and adoption professionals about safety for the family. Adoption and parenting are hard enough in and of themselves. Battling cancer is hard enough in and of itself. Trying to make all that happen together is almost unimaginable. Trying to bond with your new child, while dealing with cancer treatment, or being in-and-out of the hospital during those formative months of attachment certainly add an extra layer that we would all prefer not be there. With sufficient time and a strong letter from the doctor, it shows the family is more set up for success out of the gate.
The bottom line is, you can see there is a lot of gray in this area. But talking with your agency, being honest, and having a cooperative oncologist are going to be key.
Cancer is very common now and everyone is becoming more knowledgeable about it. It is no longer the firm “no” that perhaps it once was in the past.
Have a question we didn’t answer? Leave us a comment! And stay tuned for our next post – adopting domestically after cancer!