Adoption Preferences: A Guide for Hopeful Parents

When you begin the adoption process, one of the first real decisions you’ll face is defining your adoption preferences: the circumstances and characteristics you’re prepared to say “yes” to. This can feel overwhelming, even emotional. But understanding what adoption preferences are, why they matter, and how to approach them honestly will set your journey up for success.

At Lifetime Adoption, we’ve been walking beside hopeful families for over 40 years. We’ve seen what happens when families are thoughtful about their preferences — and what happens when they aren’t. This guide is here to help you get it right from the start.

What Are Adoption Preferences?

Adoption preferences are the guidelines you establish early in the domestic adoption process that describe the types of situations you’re open to. Think of them less as a wish list and more as a roadmap — they help Lifetime’s coordinators match you with expectant mothers whose circumstances align with what your family can genuinely support.

Your adoption preferences typically cover areas like:

• Gender of the baby
• Race and ethnicity
• Birth parent’s medical and mental health history
• Substance exposure during pregnancy
• Level of openness in the adoption
• Special needs or medical conditions

These preferences are taken seriously. They determine which expectant mothers see your family profile and, ultimately, which mothers feel drawn to choose you. That’s why it’s so important to be both thoughtful and honest when you set them.

Why Your Adoption Preferences Must Be Honest

Here’s the truth we share with every family we work with: only say yes to what you can fully embrace.

Setting broader preferences than you’re genuinely comfortable with might seem like a strategy to shorten your wait time, but it almost always backfires. Here’s why:

When an expectant mother chooses you, she’s making one of the most significant decisions of her life. She’s trusting you with her child. If a situation arises that you listed as “open to” but aren’t truly ready for, you may feel pressured to accept — or worse, you may decline, leaving a birth mother feeling rejected at a devastating moment.

At Lifetime, we always remind hopeful parents: your adoption preferences should only include what you’d say YES to without reservation. This protects expectant mothers and keeps you from beginning your parenthood journey from a place of regret.

Gender Preferences

You can indicate a gender preference in adoption, but please be aware that doing so can significantly increase your wait time to be selected by a birth parent. Since most birth mothers don’t know their baby’s gender, being gender-specific means you’ll be considered for fewer adoption situations.

One of the most common questions we hear: “We’ve already bought things for a girl, but we’d be open to either. Is it OK to hope we adopt a girl?”

It’s a fair question, and here’s our honest answer.

If deep down you’d feel disappointed adopting a boy, don’t indicate that you’re open to both genders. Turning down a baby because of gender would be heartbreaking for the birth mother involved.

There’s no “first choice” and “second choice” in adoption preferences. If you list a preference, it should be one you’d stand behind completely.

Race Preferences

Many hopeful families tell us they’re “open to any child.” We love that openness, but we also want to make sure it’s informed openness.

Transracial adoption is beautiful, and it is also complex. When you adopt a child of a different race or ethnicity, you’re not just adding a child to your family. You’re becoming a transracial family. Your child will grow up navigating a world where their identity may be questioned, and they’ll need parents who are equipped to help them do that with confidence and pride.

Before listing transracial adoption as part of your preferences, ask yourself honestly:

• Does your community include people who share your child’s racial and cultural background?
• Are you prepared to actively support your child’s connection to their culture and heritage?
• Do you understand the unique challenges transracial adoptees can face?
• Are you ready to be your child’s advocate?

If the answer is yes, being open to transracial adoption is a wonderful thing. If you need more time to learn and prepare, that’s okay too. Lifetime’s coordinators can help you think through this.

Birth Parent Health and Medical History

When you work with Lifetime Adoption, your coordinator will walk you through what’s typically known about an expectant mother’s personal and family medical history. This may include:

• Mental health history — conditions like anxiety, depression, bipolar disorder, or schizophrenia
• Physical health conditions — like diabetes, autoimmune conditions, or genetic factors
• HIV or STI exposure during pregnancy

No expectant mother will have a perfect medical history, and honestly, neither does anyone else. A helpful exercise is to honestly examine your family’s health history. Whatever you’ve already navigated or could navigate for a biological child, you can likely navigate in adoption, too.

When you’re unsure about a specific medical condition, do the research before you decide. Talk to a pediatrician. Consult with a specialist. Understanding what a condition actually means for a child’s development and quality of life often looks very different from what fear paints it as.

Substance Exposure During Pregnancy

This is one of the most common areas where hopeful adoptive parents feel uncertain, and understandably so. The reality is that many babies placed for adoption have had some level of in-utero substance exposure, whether to alcohol, tobacco, prescription medications, or drugs.

The effects of substance exposure vary enormously depending on the type of substance, the frequency of use, and the timing during fetal development. It’s not a one-size-fits-all picture.

Before setting your preferences in this area, we strongly encourage families to:

• Speak with a pediatrician or neonatologist who has experience with prenatal substance exposure
• Research specific substances rather than making blanket decisions
• Ask questions — Lifetime’s coordinators are here to help you understand what information is available about any specific situation

A few resources to learn more about specific substances include:

• The National Institute of Drug Abuse’s research report “Substance Use While Pregnant and Breastfeeding”
• Creating a Family’s article, “Busting the Myths of Prenatal Alcohol and Substance Exposure”
• Mother To Baby, a trusted source of evidence-based information on the benefit or risk of medications and other exposures during pregnancy.

Being educated here, rather than simply fearful, can open your family to opportunities that lead to healthy, thriving children. Plus, it can shorten your wait time in meaningful ways.

Level of Openness in Adoption

Your preferences will also include how open you’re willing to be in the post-adoption relationship with the birth family. At Lifetime Adoption, we believe in open adoption — and the research supports it. Children who grow up with age-appropriate access to their birth family story and, in many cases, ongoing contact, tend to have stronger identities and healthier development.

When you’re setting your openness preferences, be honest about what you can sustain long-term. Open adoption isn’t just about what sounds right today. It’s about promises you can keep for years to come. A birth mother who chooses you based on an openness agreement is trusting you to honor that agreement.

Lifetime’s team will help you think through what level of openness feels right for your family, and we’ll support you in building a healthy relationship with your child’s birth family over time.

How Adoption Preferences Affect Your Wait Time

Here’s something every waiting family wants to understand: the more open your adoption preferences, the shorter your wait is likely to be.

This isn’t a pressure tactic; it’s simply math. Families who are open to a wider range of situations are presented to expectant mothers more frequently. Families with very specific preferences may wait longer because fewer situations meet their criteria.

That said, we never encourage families to stretch their preferences beyond what they’re genuinely ready for. An honest, well-defined set of preferences (even if it’s narrower) is always better than preferences you listed to move faster but don’t truly mean.

Your Lifetime coordinator will help you understand how your preferences compare to the adoption situations we typically see, so you can make informed choices about where openness might make sense for your family.

Can You Change Your Adoption Preferences?

Yes, and it’s not uncommon. As families learn more and grow more confident, they often choose to expand their preferences. Many families tell us that after taking time to research a situation they’d initially been hesitant about, they realized they had more capacity than they thought.

If your circumstances change, or if you want to revisit your preferences at any point during your wait, just reach out to your Lifetime coordinator. We’ll walk through it with you.

A Note on the Matching Process

It’s important to understand that in domestic adoption, you do not choose your child. The birth mother chooses the family for her baby. Your adoption preferences work behind the scenes. They help Lifetime match you with expectant mothers whose situations align with your preferences, and those mothers then review your family profile and decide whether you feel like a good fit for their child.

This is one of the most meaningful parts of open adoption: the birth mother isn’t just placing her baby. She’s actively choosing the family she believes will love and raise her child well. Your job is to be honest, be prepared, and trust that the right match will come.

Frequently Asked Questions About Adoption Preferences

What are adoption preferences in domestic adoption?

Adoption preferences are guidelines you establish during the adoption process that describe the types of situations you’re prepared to accept, such as gender, race, health history, substance exposure, and level of openness. They help your adoption agency match you with expectant mothers whose circumstances align with your family.

Do adoption preferences affect how long I wait to adopt?

Yes. Families with broader adoption preferences are typically matched more quickly because more situations qualify. Families with very specific preferences may have a longer wait. That said, your preferences should always reflect what you’re genuinely ready for, not just what might shorten your timeline.

Can I change my adoption preferences after I’ve started the process?

Yes. You can update your adoption preferences at any time during your wait. Many families expand their openness as they learn more about specific situations. Contact your Lifetime coordinator to discuss any changes.

Is it OK to have a gender preference in adoption?

Yes, it is possible, but please be aware that having more specific requirements—such as a preference for your child’s gender—can mean a significantly longer wait to be chosen by a birth parent. Many birth mothers are not aware of the baby’s gender, which limits the number of adoption opportunities you’ll be presented with if you are gender-specific. If you are set on adopting a child of a particular gender, we suggest considering the adoption of a waiting child, as their gender is already known.

What happens if a birth mother’s situation doesn’t match my preferences?

You won’t be presented to her as a potential match. Your preferences work as a filter before you ever see a situation, which means you’re less likely to face a difficult decision mid-process.

Ready to Start?

If you’re hoping to adopt and want to talk through your adoption preferences with someone who’s been doing this for decades, Lifetime Adoption is here. Our coordinators are available to answer your questions and help you get started.

Call or text Lifetime Adoption at (727) 493-0933 or start your free application here.

Every family that has ever held their child looked back and said it was worth the wait. We’d love to help you get there.

Related Reading:

• Adopting a Newborn from the Hospital: What to Expect and How to Prepare
• Building Your Family Through Ethical Adoption: What You Need to Know Before You Start
• Financial Assistance for Adoption Made Simple: Grants, Loans, & More

Editor’s Note: This article was originally published on January 12, 2017, and has since been updated.