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Soumya Ranjan Parida
Basic B.Sc. Nursing 4th
Sum Nursing College
*We are guilty of many errors & many faults
But our worst crime is abandoning
The children & neglecting the Fountain of Life
*Many of the things we need can wait
the child cannot
Right now is the time , his bones are being formed
his blood is being made,
his senses are being developed
To him we cannot answer “TOMORROW”
His name is “TODAY”
Noble Prize Awardee
2) MNM (2008)
What is Adoption?
Essentially a Social Process
*Family – Parenthood by “Procreation”
Parenthood by “Adoption”
Parenthood : A fn. of Heart & not of Biology
*Needs: Adoption meets reciprocal needs
CHILD’s need for a permanent nurturing home
Adoptive Parents’s need to have child –to
Bring up as their “Own Child” &
building a family in a beautiful way
Experience – entirely emotional
3) MNM (2008)
*I longed for you,
*Though I didn’t
know your face.
*And when at last
you were chosen
*My life took on a
*We were a family.
*The moment we saw
*Her we knew she was
*That she was born only
*That fateful day , she
entered our home and
our hearts, to stay
* T0 me you are special
* Special because you
belong to me and you are
* The fact that Ididn’t give
birth to you doesn’t make
me less of a mother.
* Or you my daughter .
* For mothering is far
more than birth.
By Claire Short.
* Welcome home,
* We have been
waiting for you.
* We are a family ,
because we have
chosen to be.
Hindustan Times ,Nov. 24, 2008., pg,2
Basic Minimum :
*Creation of a parent – child relationship ,
between persons not related by birth
*Legal provision – for same rights & obligations
like that of biological child
*Adoption provides: A Permanent Family,
Permanent Home, same rights & social status
4) MNM ( 2008)
*“Transfer of Rights & Responsibilities
concerning the child from biological birth parents
to the adoptive parents irrevocably”
*Adoption an instrument through which one can
ensure UN Convention of Rights of Children
5) MNM (2008)
1. Inherent right to life, survival & development
2. Right to name & nationality
3. Child’s interest - always a prime consideration
4. Special protection from physical harm &neglect
5. No discrimination thro’ universal brotherhood
6. Social security thro’ education, employment, &
7. Special attention to disabled children.
5A) MNM ( 2008)
Practiced since ancient times amongst ancient
*Only the Hindu & Roman law provided for the
Institution of Adoption.
*Ancient mythology RIGVEDA : 13 types of sons
Except natural born , rest 12types- cons
Secondary sons of which only “Dattak Putra”
*Amongst ancient civilizations :Romans : secular
inst. Hindus : lot of religion & spirituality
From Romans , it spread to other civilizations
Babylonians, Greeks & Continental Europe
6) MNM (2008)
HISTORICAL aspects ( cont)
Incl. Czarist Russia,some countries of South America,
Japan & in England –1926, later drastically improved by
1958 Adoption Act.
Original Hindu Law – Limitations:
Not to be adopted : Deaf, dumb, orphan &
Cannot adopt : widow / unmarried woman
All hurdles removed by modern law
HINDU ADOPTION MAINTENANCE ACT,.
Modern Hindu Law of Adoption:
Who can take in adoption:
• Male Hindu sound mind >18yrs , provided has no Hindu
son , grand/or great grand sons, natural, /adopted living
at the times of adoption.
• If wife alive her consent necessary, mentally incapable,
disabled , renounced world , or ceasing to be Hindu.
• Same for daughter as in 1.
• If female wants to adopt – all rules same & husband’s
More in Adoption Law
GWAct,HAMA,SC judgment, JJAct,UN Convention
Indian Constitution on ROC, GOI circular,
Integrated Child Protection Scheme Draft [ MWCD]
*HAMA 1956 [amended 1960 & 62] : applicable all over
India except J & K.
*An unmarried /divorced/widowed Hindu female can adopt a
*A single female can make an adoption to herself in
*HAMA abrogates all pre-Act customs + usages except 2:
If custom preserved & permits :
i A married child can be adopted
ii A child of 15 yrs & above can be adopted.
7A) MNM (2008)
Who can give in Adoption?
Biological/ natural – father & mother dead/ disabled
from exercising the right bec.of mental incapacity,
renounced, only then only legal guardian can give for
adoption even only child is allowed to be given
Who can be adopted:
Hindu male/ female , unmarried , < 15 yrs of age
(exception), not already adopted.
If adopted by male: F-21 yrs younger
by female: M-21 yrs “
Ceremonies necessary for adoption
absolutely necessary: actual giving & taking of
adoptive child 7A( MNM(2008)
Ways of Receiving Children
1. Abandonment: Children found abandoned by public/police,/
individuals from public places, cradle of orphanage, hospital,
Juvenile Welfare Board (JWB)premises
2.Unwed mother : May be given, after executing a letter of
relinquishment on valid stamp paper &in a case of minor by
3 Relinquished Children: Given up by parent /parents & their
statements recorded on a stamp paper , the placement of this
relinquished child does not require to be considered by JWB
prior to being placed in adoption.
Documents sealed & kept as confidential record with
the adoption agencies as the property of court.
8) MNM (2008)
Ways of Receiving Children (cont)
4)From Care Institutions /Organizations: where
abandoned babies are cared for e.g; Manav Seva Sangh ,
Shradhanad Mahilashram etc.
*When infants /babies / children are brought there – sick,
may be injured ( deliberate – abandoned), hypothermic , due
to extreme weather, hypoglycemia , septicemia, severe
asphyxia, pallor, shock, systemic problems - GI,Resp, CNS,
RES, UT etc. No information on their prior history-
antenatal, labour, postnatal , family .
*Dr / Pediatrician must be attached , all facilities in house
for Rx or refer to nearby hospital for critical care.
*Staff -- nurse , ayah, supervisor , MSW, Administrative
*Records : regular & legal & individual child’s periodic
complete ck.up, immunization, investigations,& Rx
8A) MNM (2008)
Deciding to Adopt
Why parents adopt?
1)Major reason is to fulfill the “void”
“ vacancy “/ “deficiency” of a childless couple
2) Religious – to fulfill family obligations
Continuation of “family name”, funeral rights etc.
3). Secular - secure an heir
4) Possibility of genetic disorders in one’s biological child.
Never prudent to undertake “secret” adoption since
Emotional,Psychological , Social & Legal consequences
Adoption should always be done officially, legally.
9) MNM (2008)
Agencies involved for adoption & their functions.
1. Central Adoption Resource Agency.[CARA]
2. Licensed Adoption Placement Agency.
for in- country adoption.
3 Recognized Indian Placement Agency
f or inter - country adoption.
4. Voluntary Coordinator Agency
5 Adoption Coordination Agency etc;
Children Homes & Institutions that have
children for adoption.
Provide necessary information/ guidelines to
interested couples. 9A) MNM (2008)
Process of Adoption
* Having decided to adopt, the couple should approach adoption
agency (Fit Person Institute) by Central Govt.for correct
information/ guidance, moral support.
*Vice versa : through social worker, involves selection of child
legality and all other formalities.
Adoptive parents’ age, home study, motivation, <45yrs
*Family background , other children if any, emotional
background , health , social status, business/job- amount of time
will be given to adopted child, marital background, medical,
biological proved incapable to produce(?), sometimes adoption
of additional child – even with existing biological child.
* I had to be approved to be a father ,
* While other men didn’t have to bother .
* I had to answer queries about my life, they ask all about
me and wife.
* They asked to know if we were fit to raise a child
* I had to bare my very soul and explain .
* Most men never have to bother .
* But I needed approval to be father.
* The family broken ,mine begins, Oh who can understand
the ways of life.
* When loss and love join hands.
Bill Thompson, adoptive father.
• Special Adoption
* Secret adoptions
* Single parent adoptions
* Combination Families
* Adoption of an older
“Special Needs” child
9C) MNM (2008)
Role of Pediatrician
*Although social service: crucial & imp. role.
-- unlike other children (pts.), no antenatal ,or;
family history available,has to “ Grope in dark” ,
*Medical Examination :Objectives:
1 .To ensure medical welfare.
2. To give protection to adoptive parents
against being mislead
3. To give medical advice necessary
10) MNM (2008)
Role of Pediatrician (cont)
*Actual exam 1st
; Physical examination, Anthropometrical,
Developmental assessment, Immunization record, Noting
H/O any illness in past.
Investigations: Hb, X-ray chest (for TB), HIV, routine urine,
stool– parasites, VDRL, Hepatitis B, Torch tests, Hb
electrophoresis , TSH– newborn/LBW, chromosomal
anomalies, metabolic work up
exam: After time lag of 3 – 9 mos. Depending upon
situation esp. for International Adoption for actual
presentations of latent problems , if any.No way of
guarantying or predicting forecast from available medical
records. Most of the time all adoptive agencies /orphanages
have liaison with pediatricians for regular med. ck up.
opinion is welcome.
10A) MNM (2008)
Role of Pediatrician (cont)
Medical Care of Orphans & Adopted Babies.
1) Depends on age of baby when received in orphanage
a) Soon after birth i.e.; in the cradle deserted : may be with
placenta intact., premature, hypothermic,
hypoglycemic, rarely jaundiced, bleeding, asphyxiated.
b) After few days /mo./months: septicaemic, hypothermic,
hypoglycemic, jaundice, pallor, injury marks, bleeding
severely , marasmic, cong. anomalies, life threatening
c) Older child : maimed , bitten , injured, emotionally
traumatized, malnourished , anemia, vitamin & mineral
10B) MNM (2008)
Role of Pediatrician (cont)
Pediatrician must be alert – prompt diag.&imm. management
Three important steps:
1 Urgency of action even when slightly sick-realize to refer
immediately if critical care needed
2. Broad spectrum ABS: even for trivial infection, no chances
3. Immunization : all routine + Hep. B ,
investigations necessary as per indications.
4. Appropriate feeding
5 Facilities for IV lines, O2, nebulization, X- Ray,life saving
drugs, & M.O. with training in child care for management-
Before transferring / referring to major health care center.
Gen.Care: In House: clothing, environ., congenial atmos.
education, play area 10C) MNM( 2008)
Role of Pediatrician (cont)
Post Adoption Care:
1. Besides routine care-extra inquiry for feeding ,
sleeping patterns, love, stimulation,
development, toys/games, speech & language.
2. Patience & reassurance to parents
3. Follow up - very crucial.
Consequences of Adoption
1. No adoption which has been legally made can be
cancelled either by the adopting parents or by the
adopted child by any other person
2. Adopted child continues to vest/inherit property
vested prior to adoption.
3. Adopted child cannot marry any person whom
the adoptee could not have married if he had
continued to live in the same family of birth.
4. For all purposes , adoption takes effect from the
date of adoption
5. Registered documents absolutely must &
presumed that it is in accordance with the law.
11) MNM (2008)
Follow up & Post adoption Counseling
Necessary for advice & care of situations:
1)Sudden change crisis : anxiety , rejection, aggression or
combination due to sudden change
2) Behavior crisis: After few years : due to pampering / over
protection by adoptive parents, family members, rarely
rejection, difficult to detect as parents do not reveal
3). Communication & Identity crisis: May come up at any
age if the child’s sense of security is not well ensured by
parents/ family members – more likely in intercountry
adoptions - commonly due to change in skin color
11A) MNM ( 2008)
Follow up & post adoption counseling (cont)
4.) Crisis of Assimilation: Likely to occur in
intercountry adoptions when the child grows into
adulthood & faces a problem / discrimination in
getting a job , marriage etc.
*Wherever possible the concerned dr./pediatrician
must be able to guide/ counsel the family or refer them
to appropriate agencies.
Priority In Adoption
As per Supreme Court – Justice Bhagwati’s judgement
An Indian child will be given for adoption in
1. Indian families in India
2. Indian families in foreign countries*
3. One parent of Indian origin
4. Total Foreigners.
*An application of an Indian by Foreign Adoptive
parents, should be forwarded by Foreign Govts,
accredited agency of the country of the adoptive
parents, recognized agency in India with all the
documents to CARA [Central Adoption Resource
Agency] 12) MNM ( 2008)
Priority in Adoption (cont)
Documents needed for Adoption:
1. Birth certificates of adoptive parents, <42 yrs –
given infants ; 42 – 47 yrs given older children
2. Marriage certificate of adoptive parents( m>5yrs)
3 Certificate of good health from registered
4. Infertility report ( if available)
5. Letter of recommendation from family & friends
6. Employment , income & property certificates.
12A) MNM (2008)
Source: Ours By Choice
By Nilima Mehta
Legally in USA : 1900
UK : 1926
INDIA : 1956
Indian law :1. 1956 Adoption & Maintainance Act (HAMA)
Applicable only to Hindus ,Sikhs, Jains ,Buddhas,
Not to: Muslims,Christians,Parsis,Jews
2 Guardians & Wards Act of 1890.
Applicable to those not covered by HAMA
i)Only guardianship , both spouses
ii) no legal heirship
13) MNM (2008)
LEGAL ASPECTS ( cont)
Because of limitations of HAMA
The adoption of children bill introduced
In 1970 : In Rajya Sabha by Dr Mangla devi Talwar-
after much deliberations changes suggested.
In 1978: Reintroduced as Revised Bill, but to this date
not passed. Acceptance of this bill will benefit many
more unfortunate babies who are otherwise denied
13A) MNM ( 2008)
Inadequacy & lacunae in current
1 ) Most important Inadequacy:
Absence of uniform law for adoption which would apply to
all Indian parents(adoptive) irrespective of their
religion, caste, creed.
2) Only available law HAMA is Parent oriented & not
child oriented & besides the adoptive mother is not a
joint petitioner but only a consenting party.GWA 1890
only confers the status of a ward to to the adopted child
& not security for either the adopted child /adoptive
14) MNM (2008)
Inadequacy & lacunae in current legislation
Supreme Court Judgement - Feb, 1984: directives
for destitute children, natural & adoptive parents
& welfare agencies
• 1.Child 1st
choice for Indian adoption - failing
thrice, only then International.
• 2. Govt. intervention,
3.Importance of coordinating agencies.
14A) MNM (2008)
*Hindu religious ceremony : in which biological
parents give the child to adoptive parents who are of
the same caste, religion, creed , gotra, in the
presence of a priest & two families .
*Law has accepted this ceremony – it has to be
15) MNM ( 2008)
JUVENILE JUSTICE ACT 2000
Passed by Parliament in April 2000, still in pipeline not
adopted by all states.
(Care & Protection of the Children Act)
A new enabling legislation by which
*Any Indian interested to adopt a child can adopt
irrespective of its religious background & no. of living
sons /daughters, before this by HAMA only Hindus& by
GAWA - non Hindus
*With this new law : any person Hindu / Muslim/Parsi/
other religion, can adopt a minor M/or F irrespective of
she.he is a single parent& wishes to adopt minor of same sex
or no. of living biological children. 16) MNM 2008.
Personal Experience: F/U of adoptions
160 children age 1 wk - 6 yrs, adopted from
Manav Seva Sangh, bet.1967-79, f/u : 2 –10 yrs
Boys 63, Girls 97 , National 104, International 56,
F/U : through same agencies which had originally
All adopted children were doing well except 3 :
*1 boy – 4yrs, ill-treated by adoptive mother returned
*4 mos infant dev.resp. infec. On 4th
day of adoption
mother returned the infant,as prev.adop.died of Pn
*3 yr boy dev. Polio after 6 mos. 17) MNM (2008)
Country wise Adoptions
*Past – greatest no. from South Korea
*To-day – Columbia leading, followed by:
Brazil, Chile, India, Peru, Philippines,
Sri Lanka & Thailand .
*East European Countries , China, Russia – fast
emerging as potential source
*Russia- only allows “ special needs” children by
18) MNM (2008)
* No flesh of my flesh
Nor bone of my bone
* But miraculously my very own.
Never forget for
a single moment,
* You didn’t grow under my heart
But in it.
by Fleur Heyliger.