Adoption is Always an Option

As I reviewed the records of the women scheduled for ultrasound, I came across a client whose profile picture showed an image of a pregnant woman possibly presenting in her third trimester.  The record indicated she had come to the center just two days prior for a pregnancy test.  She had initially tested positive on a home pregnancy test 1 day before being seen in the clinic.  Her chart read, ‘no known LMP.’  When I spoke to the patient advocate who had interviewed her, I learned the client admitted she had been in denial, despite visible evidence of pregnancy.  I was informed this pregnancy was unexpected and the client had stated, ‘adoption is a possibility.’

Upon arrival to our clinic, the client completed the initial intake forms.  I then proceeded to escort her back to the counseling room rather than the exam room since I was not sure what I would do regarding her desire for an ultrasound.  Our policy in the center was to only scan women if they presented with an LMP placing them over 6 weeks gestation.  Even without a known LMP, the woman was visibly and notably well beyond that.  In fact, this woman appeared ready to ‘pop.’  Though our center policy did not state an upper limit regarding when I could or could not scan, our doctor reviewing the scans had stated a preference of me not scanning anyone beyond 24 weeks.

I began the medical history interview process with her in hopes to gather enough data to give me an estimated LMP.  Even upon questioning when each of her individual ‘symptoms of pregnancy’ began, she would only estimate to being about 2-3 months along.  However, clinical judgement via visual examination coupled with clinical experience, I ascertained the client was well beyond 6 weeks gestation and even beyond the estimated 2-3 months.   In fact, I truly believed this woman was easily within a month of delivery.  After completing the interview, I discussed with the center’s Executive Director my findings and explained the need to provide this woman with a scan to confirm a viable intrauterine pregnancy and to determine an estimated due date.  If this woman was truly as far along in the pregnancy as I believed her to be, then she would need concrete evidence demonstrating that she indeed was not only pregnant, but would be delivering a baby fairly soon.  Thus, needing to obtain prenatal care immediately for the health of herself and her baby.  Following receipt of approval to scan the client from the director, I proceeded.

Upon placing the probe on her abdomen, I immediately imaged a baby’s head in the vertex position.  But unlike the 6 to 12 week scans where the whole baby appears on the screen, all I could fit in my field of image was the baby’s head.  The BPD measurement placed the woman at 38 weeks plus 1 day.  The woman continued to converse with the client advocate throughout the scan, lamenting that this was completely unexpected, unintended.  She again mentioned, “Adoption is a possibility.” I explained to the woman about the measurement of the BPD, the dating which I had obtained, the variability of estimated due dates this late in pregnancy, and that she was in need of being seen by an OB doctor immediately.  With verbal permission from the client, our office scheduled an appointment with a local OB for her.  The discharge summary was reviewed with the client. Then, because of her gestational dating, the signs and symptoms of labor were shared with her, informing her that if she were to experience any of the symptoms of labor then she would need to go to the ER or call 911 immediately.  At this point, I offered to connect her with an Adoption Agency.  However, at the time, she was understandably feeling overwhelmed.  Therefore, she was scheduled to follow-up with us after her doctor’s appointment.

Thankfully, the client kept her scheduled OB appointment. And although she did not return to our center as scheduled, we continued to maintain contact with her via phone calls.  She again mentioned adoption, so we coordinated the initial meeting with a Pregnancy Counselor from an adoption agency.  During the process of connecting the two, I learned ‘it is never too late to choose adoption.’  In fact, even at the time of birth, a women can choose adoption through an adoption agency.  I had made the assumption that once the child was born adoption would only come after the baby was placed in the foster care system taking away the parents ability to choose the baby’s adoptive family. Thankfully, I have since found out that assumption is only a misconception. However, in that given circumstance, the woman herself would need to request an adoption agency be called into the hospital.

Still, I was beginning to get nervous about ‘if there would be time enough’ for all the details of adoption to work if the woman so chose.  But as God would have it, in His infinite wisdom and perfect timing, the birth mother was able to meet with the adoption agency pregnancy counselor just 24 hours prior to the birth of her baby.  The birth mother was offered a myriad of choices regarding the adoptive parents.  Not only was she able to choose life for her baby, but the kind of life she hoped of, even dreamed of, for her unborn child.  This particular birth mother made all of the following choices regarding the adoptive parents of her child: locale (suburban, inner-city, or rural), education level of parents, language spoken in the house, and ethnicity of parents, to name but a few.  In essence, the birth mother was able to dream for her child and then give her baby the gift of those dreams.  The adoptive couple was notified and arrived at the hospital within 24 hours following the birth of the baby.  All the details of adoption had taken place and had worked out with God’s orchestration.  Both couples, birth and adoptive, were able to bond with the baby and each other.  Additionally, both couples, birth and adoptive, were able to provide love and care to this special baby that would be blessed to have birth parents so willing to choose life and dream dreams for her, while also being blessed to have an adoptive family so willing to choose to love her as their own child.  In the end, the birth couple got to choose a dream home for their baby, all while the adoptive family now would get to have their dreams fulfilled of becoming parents by the unselfishness of an unexpectant mother and father, which occurred only 10 days following her ultrasound appointment. It truly is not ever too late for adoption, nor for God to work His amazing plan.

Staci Morgan, RN, MSN
Nurse Manager
Hope Resource Center
Bedford, IN