Adopting a child from overseas comes with a unique set of challenges. We take you through the requirements of five countries and share the lessons parents learned along the way.

Credit: Daniel Chang

Jennifer Rayno wasn't looking to adopt a child when her job as fund-raising director for the nonprofit Friends of Orphans took her to St. Damien's Pediatric Hospital outside Port-au-Prince, Haiti, in November 2007. But the way she tells it, the 6-month-old boy, who weighed 6 pounds and was recovering from malnutrition, chose her. "I leaned over his crib, and something magical happened," says Jennifer, who lives in Gainesville, Virginia, with her husband, Steve, and their two biological children: son Ezra, age 11, and daughter Ryelle, age 9. "When a nurse told me this sweet baby had been left in a basket at the hospital gates, my heart just sprang wide open. I knew I was meant to be his mother."

Last year, the Raynos were among the Americans who adopted more than 11,000 children from foreign countries. Many families found themselves particularly intrigued by the thought of adopting internationally after the tragic 2010 earthquake in Haiti. In that country alone, UNICEF reports that there are now believed to be more than 440,000 orphans.

The process of international adoption generally works like this: Prospective parents choose an accredited provider, making sure that the agency has a long record of dealing with adoptions from the country they've chosen. Then they apply to be found eligible to adopt. This usually includes undergoing a home visit from a social worker, creating a dossier about their family, and filing various forms. Next, the agency works with orphanages in the country of choice to identify a child (also called a referral). The couple will receive a photo of the child, a medical report, and videos when possible. They then file an immigration request to bring the child to the United States. The final step usually includes traveling to the country to meet the child, appear in an adoption court, and obtain an immigration visa for him or her to travel.

Adoption is governed by the laws of the country you're adopting from, federal laws, and the laws of your state. If you're considering it, these breakdowns of some of the most popular countries from which to adopt -- plus stories from adoptive families -- will be a useful guide.

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Rayno family
Credit: Courtesy of Rayno family


Jennifer and Steve Rayno's odyssey began in earnest in 2008, when they filled out paperwork with a U.S. agency specializing in Haitian adoptions, underwent a home study, filed more forms, and waited. (Adopting from Haiti can take up to two years.) Meanwhile, the Haitian government placed the baby, whom the nurses had named Damien, at an orphanage near Port-au-Prince. A complete medical and personal history had to be created for Damien before he could be legally adopted. This included making sure he had no living relatives who wanted to raise him.

Then, on January 12, 2010, the earthquake hit. "I was worried sick, not knowing what happened to Damien, and suddenly there he was on CNN, sitting beside a reporter," says Jennifer, who had visited the boy she already considered her son just a month earlier at the same orphanage, now half-collapsed. "My heart was pounding as the reporter explained how 35 children, along with four or five caretakers, were sleeping outside, running out of food and water."

Thankfully, the earthquake actually sped up the process of bringing Damien to his new home. He was able to come to the U.S. on humanitarian parole, which the Obama administration authorized after the disaster. "We held tight for directions on how to proceed with our son's adoption, and on January 20 Damien was home with us and our family was finally complete," says Jennifer.

Haiti Fast Facts

U.S. adoptions in 2010: 133 children

The children: Boys and girls through age 16

Estimated cost: $24,000 to $27,000

Key requirements: Couples must be 35 or older and have been together for ten years, and have no more than three biological children living at home. (Exceptions may be made for couples with infertility who are close to 35 and married for seven years.) The process is complex; papers must be filed with a number of different government offices, most of which don't have computers or, in some cases, a working phone.

Travel: Parents are required to travel to Haiti to meet their child and sign a statement of adoption agreement. The cost is approximately $2,500 for a five-day trip.

Wait time: Up to three months for a referral; up to 24 months to pick up the child

Advantages: There's a low incidence of alcohol or substance abuse among birth mothers. Many children have been raised by a parent or other biological relative, so there's a lower overall incidence of psychological issues compared with what can be seen in children raised in institutional orphanages.

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Hoffman family
Credit: Courtesy of the Hoffman family


Part of the appeal of adopting from Ethiopia and other developing countries is giving a loving home to children who have lost their parents to sickness or natural disasters. But there's also a higher risk of malnutrition, tuberculosis, and other life-threatening illnesses. Tymm and Laura Hoffman, of Atlanta, learned this firsthand.

In 2007, after two years of waiting for a referral for a child from China, the Hoffmans decided to adopt from Ethiopia. Nine months later, they had a referral, but just weeks after being matched with 2-month-old Brighton, they received an e-mail from the adoption agency. "We were shocked to read that our baby had been in the hospital for nine days with pneumonia, diarrhea, and then sepsis," says Tymm, who called the agency to tell them this was unacceptable. "We're a religious family, and we would have liked to do a prayer circle for Brighton. Besides, an e-mail seems so impersonal for such emotional news." Later in the week of that awful e-mail, the agency called with worse news: Brighton had passed away. He wasn't quite 8 weeks old.

Since Brighton's death, the Hoffmans have discovered several other couples whose referral children from Ethiopia died before they could bring them home. "There's no way to avoid this risk, but you can make sure that the agency you're adopting through has a long track record in a country and good communication policies," says Laura, who admits that she and her husband didn't know what to look for when they chose their first adoption agency.

The Hoffmans have had much happier days since then: They brought home a healthy 6-month-old daughter named Meron in June 2008. And as of press time, they were expecting another daughter, Mebrate, to join them in August.

Ethiopia Fast Facts

U.S. adoptions in 2010: 2,511 children

The children: As young as 3 months. Children must be under the age of 16, but they can be adopted at 16 or 17 if they are a birth sibling of a child under age 16 adopted by the same parents.

Estimated cost: $18,000

Key requirements: For an infant, both prospective parents must be 25 to 45 years old, in good mental and physical health, and with sufficient income. One parent must be a U.S. citizen, and there must be at least a one-year gap between the youngest child in the home and the adopted child.

Travel: Two trips are required. Both parents must travel for the first trip to appear in adoption court, but only one parent is required to pick up the child. Travel fees are approximately $2,500 to $3,500 per person, per trip.

Wait time: 18 to 24 months from submitting application to placement

Advantages: Wait time can be shorter than with other countries, especially for older children.

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Rienstra family
Credit: Courtesy of the Rienstra family

South Korea

Marci Rienstra, of Los Angeles, was adopted from South Korea when she was an infant. "I was lucky to grow up in such a wonderful family, and I wanted to give another child from my homeland the same experience," she says. Rienstra, her husband, Ryan, and their 6-year-old biological daughter, Lindsay, spent ten days in South Korea together when they went to pick up 11-month-old Lily. It was a chance for them to learn more about Lily's background as well as their own family heritage.

Lily immediately transferred the close relationship she'd had with her foster mom to Marci, but bonding with her new dad was another story. ?At first, I couldn't even be in the same room without our daughter crying," Ryan says. "It was difficult, but our home-study social worker explained to us that it was quite normal for an Asian infant to be wary of a Caucasian man."

Ryan took things slowly, sitting off to the side while Marci played with Lily or tucked her into bed. After a few weeks he started feeding his daughter dinner and giving her an occasional bath. "It helped to have Marci hold Lily and watch me play with Lindsay, whom she trusted right away. After about a month, Lily was giving me hugs and kisses just like her big sister did, and now she's totally Daddy's girl."

South Korea Fast Facts

U.S. adoptions in 2010: 865 children

The children: Usually 12 to 18 months old when they come home. More boys are available than girls. Older children are rare.

Estimated cost: $24,000 to $33,000

Key requirements: Couples must have no more than a ten-year age difference between them. Stringent health requirements include being no more than 30 percent overweight.

Travel: Not required, other than to pick up the child. The trip costs approximately $1,500 per person.

Wait time: 18 to 26 months; shorter if one parent is of Korean heritage

Advantages: The foster-care system provides a loving home for the child while placement is pending, as well as excellent medical care. Many health services are available for birth mothers too.

Harkness family
Credit: Courtesy of the Harkness family


Lucy and Doug Harkness of Lawrenceville, Georgia, had two biological daughters, ages 8 and 11, and thought their family was complete. "But news stories were coming out about the high number of orphans in China, particularly girls, as a result of the government's mandate of one child per household. We knew that we had enough love in our hearts to take in an abandoned child," Lucy recalls.

Waiting to be assigned a child can be the hardest part of the adoption process, and it takes a notoriously long time to adopt a child from China. The Harknesses first looked into adoption in 2005, and they were told it would take six to eight months to get a referral. After 17 months passed, the couple decided to take a different route. "We started looking at our agency's special-needs program, and we thought we could handle a child with a congenital heart disease," Lucy says. In July 2007, about two months after they first saw a photo of 2-year-old Ally, they were on their way to China to pick her up.

When the Harknesses decided to adopt another daughter, they again chose a child with a congenital heart disease, though this time their daughter's heart condition had been repaired with surgery when she was 14 months old. (Ally's condition corrected itself.) They adopted 6-year-old Alaina in January 2009; the entire process took only eight months.

China Fast Facts

U.S. adoptions in 2010: 3,401 children

The children: 85 percent female, 32 percent younger than 12 months old

Estimated cost: $20,000 to $27,000

Key requirements: Only couples may adopt, and they must be married a minimum of two years if it's their first marriage and five years if either spouse has been previously married. No more than two previous marriages are allowed for either spouse. Both spouses are required to have a high-school diploma.

Travel: At least one parent must travel to pick up the child. Travel fees are about $3,000 per person, per trip. The average stay is ten to 14 days.

Wait time for referral: Approximately five years, or six months if adopting a child with special needs (through the Waiting Child program)

Advantages: Many children are available. The country's process is well-organized, and the laws and regulations are stable and dependable.

Originally published in the September 2011 issue of Parents magazine.

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