Friday, June 12, 2015

Birthmother expenses state by state

      As a follow up my post earlier this week about choosing an ethical agency, I am going to write about another issue that I have been researching: Is it unethical to pay birthmother expenses*? Obviously we will assume the responsibility of medical bills that aren't covered by her insurance or medicaid, but what about those who are asking for help with living expenses such as rent, phone bills, groceries, maternity clothing, or gas money? What about those who are asking for a specific amount of money without giving specifics about what that money is needed for? Is that getting too close to baby buying? Is it coercive because now she feels indebted to the PAPs?

     The first important thing to know is that states vary widely in terms of if it is legal to pay living/"other" expenses, and what the cap on those expenses may be. Below is a chart of the policies of each state when it comes to fees beyond medical, counseling, and legal-- more detailed information can be found in this handout by Child Welfare Gateway. Every state allows the PAP to pay medical expenses related to pregnancy and delivery, as well as the legal fees for the adoption. Counseling is usually allowed, also, although there may be a cap on counseling fees. Since the medical, legal, and counseling laws are pretty standard, I'm not going to review those (although the link above to Child Welfare Gateway does, if you need that information).
     Whether or not living expenses can be paid (and why and how) breaks down into 4 categories: 1) flat out "no," 2) only if the mother is having pregnancy complications or other pregnancy-related medical issues that prohibit her from working, 3) only if there is prior court approval, 4) yes.  Within
that "yes" category, there are several other subgroups. Some states just group living expenses with their statements about allowing medical and legal expenses, and don't elaborate on any restrictions or specifics. Others set out clear categories of living expenses allowed, such as transportation, rent, food, phone, or maternity clothes. In some states, there is vague criteria such as "reasonable" or "necessary" or " normative standard of living." Some states require that the PAPs make payments directly to the third party (rent directly to the landlord, etc), while others mandate that any payments must go through a licensed agency, prohibiting money from ever directly changing hands between the PAP and expectant mother (Emom).
      When this is an interstate adoption, there are even more details to consider. If the Emom lives in a state with living expense policies that are more of less restrictive than that of the PAPs, it is best to just err on the side of caution and ask the court system which policies will be followed. Based on message boards, it seems like the policies in the state where the Emom lives (or where she has traveled to give birth) are the ones that will be followed. However, there are some states that have it written into their policies that their standards will trump those laid out by other states involved.
I apologize for the small font-- regardless of the size I made it on my computer, this is the largest that Blogger would post it

           Once the legalities of the specific situation have been established, the next question becomes: "This may be legal, but is it ethical?"
         There are some who believe that paying living expenses for an expectant mother is fundamentally coercive: now she owes you something, so it would be wrong for her to change her mind about the adoption. An important point here is that in every state but Idaho, money that a PAP has paid towards an Emom's expenses is non-recoverable if she chooses to parent. So, you could pay $8,000 in medical bills, $10,000 in living expenses throughout the pregnancy, and $2,000 in counseling expenses for the Emom that you have been matched with. If she changes her mind and chooses to parent, that $20,000 is gone. You can't get it back, and trying to do so is illegal (unless you have reason to believe that she never intended to place the baby and was putting on an act just to get money, which is really rare). For most of us, losing $20,000 would be a huge setback and would likely delay further adoption attempts.  I can honestly say that I understand the perspective that paying expenses is coercive, because yes, I would feel like I was owed something. That may sound terrible, but it is the reality. If I had millions of dollars then sure, I may go around helping out pregnant women with financial needs out of the charity and goodness of my heart. But I don't-- we are a middle-class family on a middle-class budget, and as much as I would like to say "Oh, it's no big deal, I'm just glad that we could help," that isn't our reality. It would be a big deal. It would be devastating. I would feel like she had done something wrong. And that right there is the issue: I should not feel like a woman has done something wrong because she chose to parent her child. I may be sad that our adoption plan fell apart-- that the child we had envisioned entering our family would never be coming home with us-- but I shouldn't feel like she has done something wrong.
       This is the reason why many states establish caps on birthmother expenses. Being allowed to give $500 or $1,000 is very different than giving $1,200 a month or a lump sum of $8,000 (both of which are numbers I have seen on available situation profiles from other agencies/facilitators this month). I personally don't think I would have such strong emotions about the money side if I lost $1,000 or less in birthmother expenses-- of course there would still be sadness that a match fell through, but that feeling of "she wronged us" wouldn't be there.
       So, for us, we see living expenses as a gray area. If an Emom is asking for so much in living expenses that it would devastate our adoption fund to lose that money, we wouldn't be comfortable with that match. We don't want to create a "You owe us" situation, so we would personally see it as unethical to pay a high figure in living expenses.
       Continuing through this cycle, let's say that your state allows living expenses, and you have decided that you don't feel like it is unethical for you to pay a certain amount (i.e., you wouldn't feel like she "owes" you and you would be comfortable reassuring her of such). There are a few important legal things to remember at this point. First, save every receipt. Most states will require a thorough accounting of these expenses at the time of adoption finalization-- they basically want to double check that no one bribed the biomom into placing the baby for adoption, which would in essence be buying a baby. Second, be certain of the laws about when and how money is allowed to change hands for all states involved. Can the PAP just send the Emom a check? Does it have to go through an agency or lawyer? Does the court need to pre-approve the payment of expenses?  Finally, be aware of value caps for gifts. Maybe there won't be living expenses paid, but we would really like to get some kind of meaningful present for the biomom. I was reading on a message board where a PAP had picked out a Tiffany bracelet, and others were discussing generous presents that they were considering, such as a new laptop for school since the primary motivation for the adoption had been that she could stay on track with her educational and career goals. The problem is that in some states this would not be legal. Gifts may be capped at $100-$200 dollars, while some states do not allow gifts to be exchanged at all. Instances of taking the Emom to dinner or out for coffee or seeing a movie together are considered "gifts" in some states if the PAP picks up the tab, so it is important to ask about policies before you take your credit card out for anything.
    I think that's all I know about birthmother expenses! I'm sure that I will have more thoughts on this after we match and our specific situation begins to unfold.

*These are always referred to as "birthmother expenses"-- by agencies, legal statutes, lawyers, everywhere. Birthmother isn't the term I prefer, but that is the term that seems to be officially used for this issue.


  1. A perfect example of why paying expenses is so problematic (and why "pre-birth matching" should be outlawed completely):

    1. Ooh... As a foster baby who developed difficulty forming attachments because of being sent to a temporary home at birth, and not directly to adoptive parents.. I can personally testify that outlawing prebirth matching is harmful to the newborn.
      It took me a long time to be able to form attachments at all, after being in foster homes.
      In fact, I still have issues.
      I wish I'd have had adoptive parents to take me home at birth...

  2. I disagree with prebirth matching being outlawed.
    I agree that there are issues. It's not a perfect system.
    But I personally don't want this baby I carry now to be born without adoptive parents there and ready to love her and take her home.
    I don't want her in a foster home-
    I was adopted myself, from foster care at 6 months.
    Not having a real family or a loving bond withadoptive parents right away, caused some real psychological damage.
    For a long time, I had difficulty bonding as an infant and toddler.
    It's unhealthy for a baby to not be able to have that, it causes attachment issues.

  3. I also don't agree with outlawing pre-birth matching. There are some situations where the biomom knows that she will not be able to parent the child, whether it is that CPS would get involved and the child would go into foster care or she is in prison or some other reason. In situations where she is certain that the baby would not be able to remain in her care (or in situations where she is as sure as she can be that she wants to relinquish custody of the baby), there can be great value to pre-birth matching. I am very thankful that we have had a chance to get to know Anne and Ben, and Anne has told us that she has really appreciated us being willing to speak with her and visit her so that she can feel like she knows us. I don't think that pre-birth matching and "birthmother expenses" are necessarily two sides of the same coin, but I can understand why some people see it that way. I believe that there would be ways to create better guidelines about "birthmother expenses" without outlawing pre-birth matching. However, I do think that matching should be postponed until at least the second half of the pregnancy (if not until the last trimester).

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