FACTSHEET 

FOR FAMILIES

July 2014

Intercountry Adoption: 

Where Do I Start?

WHAT’S INSIDE

Deciding if intercountry 

adoption is right for 

your family

Determining from which 

country to adopt

Finding an adoption 

services provider

Adopting a child

Meeting immigration 

and citizenship 

requirements

Adjusting to your new 

family

Intercountry adoption continues to be an option 

for parents who choose to adopt. This factsheet 

provides an overview of the intercountry adoption 

process. Depending on your State, your adoption 

services provider, and the country from which 

you adopt, the steps in this adoption process may 

vary and may change over time. For example, 

some families will first select an adoption services 

provider; their choice of country will then be 

limited to the countries with which that provider 

works or from which the parents are eligible to 

adopt. In every case you must meet the basic 

requirements of U.S. immigration law.

The number of U.S. citizens adopting children 

from other countries increased dramatically 

beginning in 1990, when 7,000 children received 

visas to come to the United States for adoption. 

This continued until 2004, when 22,991 children 

received such visas (U.S. Department of State, 

n.d.-b). After peaking in 2004, these numbers 

began to decline, and in 2013, 7,094 children were 

adopted from other countries (U.S. Department of 

State, 2014). 

Children’s Bureau/ACYF/ACF/HHS

800.394.3366 | Email: info@childwelfare.gov | https://www.childwelfare.gov
Intercountry Adoption: Where Do I Start? https://www.childwelfare.gov

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The Hague Convention

The Hague Convention on Protection of Children 

and Co-operation in Respect of Intercountry 

Adoption (the Convention) is a multilateral treaty 

between the United States and, as of August 

2013, 89 other countries (U.S. Department of 

State, 2013). The Convention provides necessary 

and important safeguards to protect adopted 

children, biological families, and adoptive families 

in adoptions between participating countries, 

including the prevention of the abduction, sale, or 

trafficking of children. 

There are two processes for adopting from 

Convention and non-Convention countries. 

For more information, see the Information 

Gateway factsheet Intercountry Adoption From 

Hague Convention and Non-Hague Convention 

Countries at https://www.childwelfare.gov/pubs/

factsheets/hague.pdf. 

Deciding If Intercountry Adoption Is 

Right for Your Family

Intercountry adoption is just one way to build a family 

through adoption. Other options include adoption from 

domestic foster care and domestic infant adoption. Many 

families consider the following issues when deciding 

whether intercountry adoption is right for them:

 Adoptiveparentrequirements. U.S. Citizenship and 

Immigration Services (USCIS), which must approve 

all intercountry adoptions, has two basic eligibility 

requirements for prospective adoptive parents: 

Prospective adoptive parents must be U.S. citizens 

and, if unmarried, must be at least 25 years old when 

they file the petition to adopt. For married couples, 

USCIS has no age requirement, and only one spouse 

must be a U.S. citizen. Persons applying to adopt from 

a Convention country also must reside habitually in the 

United States. (For a definition of “habitually resident,” 

visit http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=

div5&view=text&node=8:1.0.1.2.8&idno=8%20-%20

8:1.0.1.2.8.3.1.4 and scroll down to §204.303).

 Timeframe. Like any adoption, intercountry 

adoption involves some uncertainty. The length and 

predictability of the process vary depending on the 

country, adoption service provider, and individual child 

involved, but it generally takes from 1 to 5 years to 

complete an intercountry adoption. 

 Reasonthechildneedstobeadopted.Children 

in other countries need adoptive families for many of 

the same reasons children in the United States need 

foster care and adoptive families. These reasons 

may include poverty, illness or death of the parents, 

abandonment, or family issues such as substance use 

or child maltreatment. Other factors that contribute 

to the child’s need for a permanent family include the 

country of origin’s government policies on population 

control, the country’s economy, war, famine, natural 

disasters, and others. It is helpful to understand what 

these factors are in the specific countries you are 

considering.

 Child’sage. In 2012, 10.4 percent of children adopted 

internationally were younger than 12 months old, 42.7 

percent were ages 1 to 2 years, 15.0 percent were 

ages 3 to 4 years, 23.7 percent were ages 5 to 12 

years, 7.7 percent were ages 13 to 17, and less than 1 

percent were 18 years or older (U.S. Department of 

State, Bureau of Consular Affairs, Office of Children’s 

Issues, n.d.-a). In 2003, 45.8 percent of the intercountry 

adoptions were of children under 1 year, but the 

international adoption of children less than 1 year of 

age has become increasingly less likely over time. 

A variety of factors have contributed to the recent 

demographic changes in intercountry adoption, but 

two of these factors are the internal social changes 

in countries of origin (i.e., the country from which 

the child was adopted) and the rise of a vibrant and 

economically more independent middle class. With 

the growth of the middle class in some large countries, 

more families residing in those countries seek to 

domestically adopt newborn and healthy children. This 

may be a result of factors in the country of origin, such 

as changes to government policies in favor of domestic 

adoption or political choices limiting adoption with the 

United States. 
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Another possible factor is the Convention’s focus on 

the principle of subsidiarity. This principle states that 

a child should be placed with his birth or extended 

family whenever possible and that other permanent 

forms of family care in the country of origin should be 

considered prior to intercountry adoption. Intercountry 

adoption is not a last resort, however, as it is viewed as 

preferable to the child being placed in an institution or 

a series of temporary foster homes (Hague Conference 

on Private International Law, 2008).

According to U.S. immigration law, children must 

be younger than 16 years old on the filing date of 

the immigration petition in order to be eligible 

to immigrate to the United States for purposes of 

adoption. (There are some exceptions to this. For 

additional information, refer to I am a U.S. Citizen: How 

Do I Immigrate an Adopted or Prospective Adopted 

Child or Help My Adopted Child Become a U.S. Citizen 

or U.S. Permanent Resident? at http://www.uscis.gov/

sites/default/files/USCIS/Resources/A3en.pdf.)

 Eligibilityforadoptionandimmigrationtothe

UnitedStates. U.S. Immigration laws (the Immigration 

and Naturalization Act and the Intercountry Adoption 

Act of 2000) require children entering the United 

States for purposes of adoption to be classified as 

“orphans” (if they are from non-Convention countries) 

or as “Convention adoptees” (if they are from 

Convention countries), as defined by these laws. (For 

more information, refer to I am a U.S. Citizen: How Do 

I Immigrate an Adopted or Prospective Adopted Child 

or Help My Adopted Child Become a U.S. Citizen or 

U.S. Permanent Resident? at http://www.uscis.gov/

sites/default/files/USCIS/Resources/A3en.pdf.)

Adoption of Relatives

Prospective adoptive children who are related to 

the petitioner(s) (i.e., the prospective adoptive 

parent(s)) must qualify for adoption and 

immigration to the United States under all the 

same criteria as unrelated children. Relatives may 

be able to adopt if the children qualify as orphans 

or Convention adoptees. The requirements 

depend on the country in which the relative lives. 

(Information regarding specific requirements 

can be found in I Am a U.S. Citizen: How Do I 

Immigrate an Adopted or Prospective Adopted 

Child or Help My Adopted Child Become a U.S. 

Citizen or U.S. Permanent Resident? at http://www.

uscis.gov/sites/default/files/USCIS/Resources/

A3en.pdf.)

Determining From Which Country 

to Adopt

Parents consider many issues when deciding from which 

country to adopt and often find it helpful to compare 

adoption programs in several countries before making 

a final decision. The following considerations may be 

helpful when selecting a country:

 Eligibilityrequirementsforadoptiveparents. In 

addition to U.S. immigration rules, each country has 

its own requirements for prospective adoptive parents 

based on characteristics such as age, marital status, 

sexual orientation, family size, parents’ health, religion, 

and others. Each State also has its own requirements. 

Requirements also may differ based on whether the 

country of origin participates in the Convention. To 

view a list of Convention countries, visit the State 

Department website at

http://adoption.state.gov/hague_convention/countries.

php. 

 Agesofavailablechildren. The ages of children 

needing adoptive families vary widely, from 6 months 

to 16 years, depending on the country. The Convention 
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and laws in some countries require that due 

consideration be given to placing an infant or toddler 

with a family in that country where appropriate and in 

the child’s best interest before making a determination 

to proceed with an intercountry adoption. In those 

countries, infants younger than 6 months to a year 

old may not be available for intercountry adoption. 

Also, some countries have regulations prohibiting the 

separation of siblings.

 Ethnicity/Race/Culture. Depending on the country 

you select, your child’s ethnic, racial, and cultural 

background might be different from your own. 

Resources for transracial or transcultural families 

are available on the Information Gateway website at 

https://www.childwelfare.gov/adoption/types/families/

trans_info.cfm. 

 Child’splacementsetting:Institutionorfoster

care. In many countries of origin, children who need 

permanent families are cared for in institutions or 

orphanages. Spending time early in life in institutions 

can cause harmful and sometimes permanent effects 

in children, such as higher rates of developmental 

delays and behavior problems and decreased motor 

development and growth than in children who 

were not institutionalized or who spent less time 

in institutional care (Groza, Ryan, & Thomas, 2008; 

Johnson & Gunnar, 2011; Levin, Zeanah, Fox, & Nelson, 

2014; Merz & McCall, 2010). The age a child enters an 

institution, the length of time in institutional care, and 

the quality of institutional or foster care are important 

factors to consider when adopting.

Some countries place children waiting for permanent 

families with foster families. Research suggests that 

children placed with foster families may have better 

cognitive and health outcomes than children placed in 

institutionalized care (Nelson et al., 2007; Miller, Chan, 

Comfort, & Tirella, 2005). 

 Travelrequirements. Nearly all countries require 

prospective adoptive parents to travel to the country 

to complete the adoption process. The number of 

trips (generally one or two) and the required length 

of stay in the country vary. Traveling to the child’s 

country of origin may offer the additional benefit 

to parents of learning about the child’s culture. (For 

more information about adoption travel, read the 

the Adoptive Families magazine article “The Top 10 

Secrets of Successful Adoption Travel” at http://www.

adoptivefamilies.com/pdf/10_tips.pdf.) 

 Cost. Costs also vary widely depending on the 

country, service provider, and the needs of the child 

available for adoption. They can range from $15,000 to 

$45,000 or more (Adoptive Families, n.d.; Child Welfare 

Information Gateway, 2011). Accredited adoption 

service providers should provide a comprehensive 

schedule of expected fees. For more information 

about the costs of intercountry and other types of 

adoption, read Costs of Adopting at https://www.

childwelfare.gov/pubs/s_cost/index.cfm. 

Each country has different intercountry adoption 

guidelines. For country-specific information about 

Convention participation, eligibility requirements for 

prospective adoptive parents and for children to be 

adopted, and alerts and notices, visit http://adoption.

state.gov/country_information.php. The countries 

from which children were most frequently adopted 

internationally in 2013 include China, Ethiopia, and 

Ukraine (U.S. Department of State, Bureau of Consular 

Affairs, Office of Children’s Issues, 2014). 
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Finding Support

Talking with other adoptive parents about their experiences in different countries can help you with your 

decision. You can meet other parents through a support group for families who have adopted from certain 

countries or regions. To find a listing of adoptive family support groups in your area, refer to the National 

Foster Care and Adoption Directory at https://www.childwelfare.gov/nfcad. If you cannot find a support group 

that meets your needs, there are message boards and online support groups for adoptive parents and those 

considering intercountry adoption.

Additionally, adoptive families, including those who adopt from other countries, may at some point need to 

access postadoption services. Prospective adoptive families should begin working with their adoption services 

providers to determine potential service needs before the adoption is finalized. Examples of postadoption 

services include support groups; therapy or counseling; respite care; camps, social events, and heritage 

activities; educational resources; and openness, search, and reunion (Child Welfare Information Gateway, 2012). 

The availability of services may vary depending on your State or locality; however the Federal government 

encourages States to provide postadoption services to any family that needs them, including those that adopted 

from other countries (U.S. Department of Health and Human Services, Administration for Children and Families, 

2014). To view more information on potential postadoption services by State, visit Child Welfare Information 

Gateway at https://www.childwelfare.gov/adoption/adopt_assistance/questions.cfm?quest_id=7. 

The following are additional resources for postadoption services:

 Post Adoption (U.S. Department of State) 

http://adoption.state.gov/adoption_process/how_to_adopt/postadoption.php

 Finding and Using Postadoption Services (Child Welfare Information Gateway) 

https://www.childwelfare.gov/pubs/f_postadoption.cfm

 Selecting and Working With a Therapist Skilled in Adoption (Child Welfare Information Gateway) 

https://www.childwelfare.gov/pubs/f_therapist.cfm

Finding an Adoption Services Provider 

As of July 14, 2014, all agencies or persons providing any 

of the six specific intercountry adoption services defined 

in the accreditation regulations of the Intercountry 

Adoption Act must be accredited or approved to the 

standards set forth in the Convention regardless of 

whether the adoption will fall under the Convention or the 

orphan (non-Convention) process. An adoption service 

provider that is not accredited or approved may provide 

intercountry adoption services under the supervision of 

an accredited or approved provider or as an exempted 

provider. This is due to the implementation of the 

Intercountry Adoption Universal Accreditation Act of 

2012 (UAA) (P.L. 112-276). (For more information about the 

UAA, visit http://adoption.state.gov/hague_convention/

agency_accreditation/universal_accreditation_act.php.) 

According to the Intercountry Adoption Act, adoption 

services include the following:

 Identifying a child eligible for adoption and arranging 

an adoption

 Securing the necessary consent to termination of 

parental rights and to adoption

 Performing a background study on a child or a home 

study on a prospective adoptive parent and reporting 

on such a study

 Making nonjudicial determinations of the best interests 

of a child and the appropriateness of an adoptive 

placement for the child

 Monitoring a case after a child has been placed with 

prospective adoptive parents until final adoption
Intercountry Adoption: Where Do I Start? https://www.childwelfare.gov

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 Assuming custody and providing (including facilitating 

the provision of) child care or any other social service 

pending an alternative placement, when necessary 

because of a disruption before final adoption [22 CFR 

§ 96.2] 1

Adoption service providers also may prepare families 

for an intercountry adoption, but this is not listed as an 

adoption service by the Intercountry Adoption Act. To 

find an accredited and approved service provider, visit 

http://adoption.state.gov/hague_convention/agency_

accreditation/agency_search.php. For a list of agencies 

denied accreditation, visit http://adoption.state.gov/

hague_convention/agency_accreditation/deniedagencies.

php. 

Take time to research and carefully select your adoption 

services provider. Many have detailed websites that 

can provide valuable information for your search. An 

experienced, reputable adoption services provider should 

be willing to walk you through the adoption process, 

help you prepare to become adoptive parents (through 

educational classes on parenting and adoption issues or 

referrals to such programs), contact USCIS for you about 

immigration regulations and forms, help you handle 

problems along the way, and provide support after you 

bring your child home. Remember that the country from 

which you plan to adopt may help determine which 

adoption services provider you use.

Before deciding on a provider, attend information 

sessions or orientations and ask questions about the 

services provided. Reputable adoption providers will 

answer your questions openly, including those about 

costs. These initial sessions are usually free. Visiting 

several different providers may help you find the one that 

best meets your needs. You can also ask to speak to other 

adoptive families who used the provider’s services or 

check with your local Better Business Bureau. 

To help you determine whether an adoption services 

provider is reputable, see the tips in Information 

Gateway’s How to Assess the Reputation of Licensed, 

1 For information on adoption disruption, refer to Information Gateway’s 

Adoption Disruption and Dissolution at https://www.childwelfare.gov/pubs/s_

disrup.cfm. 

Private Adoption Agencies (https://www.childwelfare.gov/

pubs/twenty.cfm). 

Questions to ask adoption services 

providers:

 By which State is the provider licensed? Is the license in 

good standing?

 How long has the provider been involved in 

intercountry adoptions?

 Has the provider ever been denied accreditation? 

Why? 

 In which countries does the provider have intercountry 

adoption programs? How long has it had programs in 

those countries? 

 How many children has the provider placed (both from 

the country of interest and overall)? 

 What are the provider’s minimum requirements for 

prospective parents?

 Does the provider have overseas staff or use the 

services of facilitators or lawyers?

 How do the provider’s contacts (such as staff, 

facilitators, or lawyers) that work in other countries 

identify children needing families? Do they travel 

regularly to the countries of origin?

 What, if any, is the refund policy if an adoption does 

not occur or if the country closes to adoptions? Can 

they provide that policy in writing?

 What services are provided after your child comes 

home? How long are they available?

 Does the provider offer all adoption services? Which 

other organizations may be involved in providing some 

of these services in a specific case? (For example, if 

your adoption provider is only helping conduct your 

home study, ask which other providers may help 

identify a child for adoption, obtain the termination of 

the birth parents’ parental rights, or monitor the case 

until the adoption is finalized.) 

 Are there other families who have adopted a child with 

similar circumstances with whom you can talk?

 What training or support does the provider offer to 

help parents prepare to adopt and then parent a child 

with special needs?
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 If birth family members are available, what supports 

does the provider offer to facilitate and support 

contact, either during the trip for adoption or after 

adoption?

 What training or support does the provider offer to 

help parents prepare to adopt and then parent a child 

who is culturally or racially different?

 Does the provider offer a written contract that outlines 

the services offered, fees, and expectations of the 

client and provider?

 Does the provider provide any services in the unlikely 

event that the adoption is dissolved?

 What happens if you change your mind and decide not 

to adopt?

 How does the adoption service provider receive 

referrals (the packet of information about a potential 

adoptive child)?

Find more questions to ask in “What to Ask Before 

Choosing an Adoption Agency” from Adoptive Families

magazine: http://www.adoptivefamilies.com/articles.

php?aid=327. 

Adopting a Child

Your adoption services provider should provide you 

with all of the information you need to successfully 

meet eligibility requirements for adoption. For example, 

all prospective adoptive parents need to complete 

a home study, submit immigration forms, and put 

together a dossier, which is a collection of the family’s 

personal records (e.g., proof of identity, finances, 

health, fingerprints for clearance checks) required by 

the country’s legal system to process the adoption. 

Parents also are required to complete at least 10 hours of 

training prior to the adoption, which is separate from any 

home study requirement. Countries of origin may have 

additional training requirements for parents. Parents may 

be exempted from training by the primary provider if the 

parents already have completed other sufficient training.

A few months to a year or more after completing the 

required paperwork, your family may be chosen for a 

specific child for possible placement, or your family may 

receive a specific child profile for consideration. This 

process varies greatly depending on the country and 

adoption provider involved. In a few countries, families 

might be allowed to be directly involved in this step by 

visiting orphanages and viewing photolistings of waiting 

children. Waiting to be matched with a child is often 

one of the hardest and most unpredictable parts of the 

adoption process. 

When a specific child is identified, you will receive a 

referral (a packet of information about the child). Although 

the level of detail varies depending on the country of 

origin, this packet usually includes the child’s picture and 

information on the child’s health and history, if available. 

Medical information and history may be inaccurate or 

limited to the period of time since the child’s placement 

in an orphanage or institution. You will have a period 

of time to review the information and decide whether 

you can meet this child’s needs. In general, prospective 

parents have a minimum of 2 weeks in Convention cases 

to consider all the available information and make a 

decision. Ask your provider or a doctor who specializes 

in adopted children any questions you have before you 

accept the placement. Take as much time as you need 

to feel comfortable with your decision, paying particular 

attention to the information related to the child’s health, 

prenatal health (if known), placement history, and 

expected emotional or mental health needs. Do not 

be afraid to ask for additional information, particularly 

if a professional raises issues that concern you. Make 

sure your family can meet the needs of the child. If you 

are unsure about whether you can make the changes 

necessary to incorporate the child into your family, it is 

better to stop the process prior to meeting him or her 

than to risk a possible disruption or dissolution down the 

road. 

Health and Behavioral/Mental Health 

Considerations 

When reviewing the information of a child with whom 

you are matched, you should consider their expected 

health and behavioral/mental health needs. In a study 

of more than 1,000 parents who adopted from abroad 

(with 92 percent of parents from the United States), nearly 
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half (47 percent) adopted a child with special needs 

(Pinderhughes, Matthews, Deoudes, & Pertman, 2013). 

Of those children with special needs, half received an 

initial diagnosis in their birth country, and half received a 

diagnosis after the adoption was finalized. Additionally, 

42 percent of the children diagnosed in their home 

country as having a special need were diagnosed with 

an additional special need after having been adopted. 

Therefore, parents often learn of a child’s special need 

after placement, whether or not they had planned and 

prepared to adopt a child with special needs.

Healthneeds.The type and quality of available medical 

information will vary depending on the country and the 

child’s situation. Reputable providers will give you as 

much information as possible about a child’s background 

and medical history, but they cannot guarantee the 

information is accurate or complete. Health records 

will be in the child’s language of origin and may need 

to be translated. Sometimes translated records are not 

complete or accurate, and parents should consider 

requesting copies of the original medical records so that 

local health professionals who are fluent in that language 

can translate them. Many factors influence the health of 

children who need families in other countries. Children 

often have health conditions that are common in lowresource countries but that can be easily treated in the 

United States. Children’s health also can be affected by 

living in institutions. A doctor familiar with intercountry 

adoption can help you understand the information you 

receive about the child’s health and development. 

Behavioral/mentalhealthneeds. Children in other 

countries enter their country’s child placement systems 

for many of the same reasons children enter foster care 

in the United States, including malnutrition, parental 

substance abuse, prenatal exposure to alcohol and other 

drugs, physical and sexual abuse, or neglect. In many 

countries, children waiting for adoption live in institutions, 

where they are sometimes exposed to physical or sexual 

abuse and/or neglect. Sometimes a child may not feel 

safe to share information with anyone, particularly about 

sexual abuse, until he or she feels comfortable in his or 

her adoptive family, so the adoptive family may be the 

first learn about abuse. It is important to be aware of 

the possible effects of these experiences on children’s 

behavioral/mental health so you can have realistic 

expectations about the child’s future needs. Research on 

domestic adoptions of children with special needs shows 

that families that have realistic expectations about what 

it will take to meet a child’s needs are more likely to be 

successful (Reilly & Platz, 2003).

Meeting Immigration and Citizenship 

Requirements 

The legal adoption or guardianship process begins 

after you accept a referral for a specific child. In some 

countries, families are required to travel to the child’s 

country of origin to finalize the adoption in the foreign 

court. In others, guardianship of the child will be 

transferred to the prospective adoptive parents or to their 

adoption services provider, but they must finalize the 

adoption in U.S. courts to fulfill USCIS requirements. Even 

if a trip is not required, experiencing your child’s country 

of origin firsthand can give you a deeper understanding 

of what his or her life was like before joining your family. 

Traveling with a group of other prospective adoptive 

parents can help you form supportive relationships with 

other adoptive families that can last for years.

In the case of a child from a Convention country, it is 

important that you do not adopt or accept legal custody 

of the child until: 

 USCIS has provisionally approved the petition to 

classify the Convention adoptee as an immediate 

relative (Form I-800) AND

 The U.S. Department of State has advised the country 

of origin’s Central Authority, which is the entity that 

ensures the adoption process is safeguarded, that 

the prospective adoptive parents have been found 

suitable and the child appears eligible to come to the 

United States if adopted or if legal custody for the 

purpose of adoption is granted

There may be additional actions required by U.S. 

immigration law, State law, your child’s country of origin, 

or your adoption provider before or after you bring your 

child home. Requirements will vary depending on the 

type of immigrant visa your child received. Your adoption 
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provider can tell you more about what must be done in 

your specific case.

You may need to:

 Submitpostplacementreportsandpictures. Not 

all countries require follow-up reports; some require 

annual reports for 5 years or perhaps until the child 

is 18 years old. Ensuring these reports get filed in 

a timely manner helps foster positive relationships 

between the United States and your child’s country 

of origin, paving the way for future intercountry 

adoptions.

 ReadoptyourchildinaU.S.courtandobtainaU.S.

birthcertificate. It is generally a good idea to readopt 

if your child is not from a Convention country. If your 

child is from a Convention country, readoption is not 

required. Your adoption provider should provide you 

with the forms you need to obtain U.S. citizenship for 

your child. For more information on State laws and why 

readopting in the United States may be beneficial in 

some cases, visit Child Welfare Information Gateway 

at https://www.childwelfare.gov/adoption/types/

intercountry/readoption.cfm. 

 Obtainproofofyourchild’sU.S.citizenship. Either 

a Certificate of Citizenship issued by USCIS or a U.S. 

passport provides proof of U.S. citizenship for children 

who become citizens through adoption. (See the 

following box titled “Proof of Citizenship” for more 

information.)

Proof of Citizenship

A Certificate of Citizenship issued by USCIS or a U.S. passport issued by the U.S. Department of State provides 

proof of U.S. citizenship for children who become citizens through adoption. This is different from the certificate 

provided with Convention adoptions, which is issued at the time of adoption, affixed to the foreign adoption 

decree by the U.S. Department of State, and states that the adoption is in compliance with the Convention. The 

process for obtaining the Certificate of Citizenship depends on the type of visa your child was issued. 

 IR-3orIH-3Visas: A child who has a full and final adoption in his or her country of origin and who enters the 

United States on an IR-3 visa (non-Convention adoption) or an IH-3 visa (Convention adoption) becomes a 

citizen automatically upon entering the country if he or she is under 18. In these cases, the child will receive 

a Certificate of Citizenship from USCIS within 45 days of entering the United States. (There are exceptions to 

this process for U.S. military employees and those who work for the U.S. Department of State.) 

 IR-4orIH-4Visas: If your child entered the United States on an IR-4 visa (non-Convention adoption) or IH-4 

(Convention adoption), you must finalize your child’s adoption in a U.S. court to satisfy Child Citizenship 

Act requirements (unless the child was officially adopted in the child’s country and the child’s State of 

residence in the United States recognizes the foreign adoption without a requirement to readopt). Your child 

automatically will become a U.S. citizen on the day the adoption is finalized in the United States provided the 

child is under the age of 18 on the date of adoption. You may then apply for a Certificate of Citizenship by 

submitting Form N-600, Application for Certificate of Citizenship (http://www.uscis.gov/n-600). If these steps 

are not completed, the child may not have attained U.S. citizenship. See http://adoption.state.gov/us_visa_

for_your_child/citizenship.php for more information.

Check the stamp on your child’s passport to see which type of visa your child was issued.

It is possible to obtain a passport from the State Department (see http://travel.state.gov/passport/

passport_1738.html) for a child before receiving the Certificate of Citizenship, but the adoption must be full 

and final according to Federal law. The “full effect” of a foreign adoption decree means that adoptive parents 

and adopted children have the same rights and obligations as they would have if a State court had issued the 

adoption decree.
Intercountry Adoption: Where Do I Start? https://www.childwelfare.gov

10

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Available online at https://www.childwelfare.gov/pubs/f_inter/index.cfm

 ObtainaSocialSecuritynumberforyourchild.The 

Social Security Administration will assign your child a 

social security number before you obtain proof of U.S. 

citizenship; however, you will need to provide proof 

that a full and final adoption has been completed. 

Records will not show your child is a U.S. citizen until 

you provide this proof. For more information, refer to 

Social Security Numbers for Children at http://www.ssa.

gov/pubs/EN-05-10023.pdf. 

Adjusting to Your New Family 

Adjusting to a new family and culture may be challenging 

for your child. Children who have spent most of their 

early lives in an institution must adjust to living in a 

family. Receiving one-on-one attention, sleeping alone, 

and owning things may be completely new experiences. 

Children often have trouble with new eating and sleeping 

schedules and with changes in diet, tastes, smells, and 

other cultural differences. Keeping some items familiar to 

the child—such as a favorite blanket or article of clothing 

or familiar-looking items from the child’s country of 

origin—or serving the child’s favorite or most-eaten food 

may ease the transition and provide important mementos 

for the future. Older children also may struggle with 

language, school, and other issues and may need more 

time to adjust. Additionally, some children, especially 

those previously placed in institutions, may experience 

difficulties forming healthy attachments (i.e., emotional 

connections) with their parents (Zeanah, Smyke, Koga, 

& Carlson, 2005), but parents may be able to help their 

children build or enhance healthy attachments using 

various nonintrusive techniques or supports (Child 

Welfare Information Gateway, 2009).

Soon after your child arrives in the United States, you 

should take him or her to a pediatrician who is familiar 

with the American Academy of Pediatrics policies 

on intercountry adoption and who has experience 

in intercountry adoption. There are many clinics and 

doctors around the country that specialize in international 

adoption medicine. (See Additional Resources for 

websites that provide clinic and doctor listings.)

Your family also must adjust to your new status as a 

transcultural and possibly transracial family. Issues 

for families to consider include whether they plan to 

participate in activities linked to the child’s culture of 

origin and, for transracial families, how to respond to 

comments or questions from others about their adoption 

and the family’s racial differences. Learning how to 

navigate these experiences can pose a challenge for 

some families. Parents who have not joined an adoptive 

parent support group may wish to do so to share the joys 

of parenting, learn from each other’s experiences, and 

help each other overcome challenges. Adoptive parents 

also need to be aware of the effect that the adoption 

may have on other children in the family and on extended 

family members.

With the enormous amount of information 

available online and increasing Internet access 

throughout the world, more and more adopted 

persons, including those adopted from other 

countries, and their birth families are finding each 

other online (Pinderhughes, Matthews, Deoudes, 

& Pertman, 2013). Regardless of the existence of a 

contact agreement, adopted children and youth 

frequently search for their birth families and vice 

versa. Adoptive families should seek assistance 

from their adoption services provider about 

how they can support their children in safely 

navigating the Internet and how to navigate any 

newly established relationships with the child’s 

birth family. For more information about open 

adoption and contact with birth families, visit 

Child Welfare Information Gateway at https://

www.childwelfare.gov/adoption/adoptive/

contacts.cfm.

During this transition and throughout your lives as an 

adoptive family, staff from the adoption services provider 

may be a valuable source of support. Some adoption 

agencies provide services for adoptive families, which 

may last from about 6 months to several years after 

placement, to make sure your child is adjusting well. 

Adoptive parents also can locate resources and referrals 

for additional services they need from a variety of sources, 

such as the Internet or the local library. It is normal for 
Intercountry Adoption: Where Do I Start? https://www.childwelfare.gov

11

This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare Information Gateway. 

Available online at https://www.childwelfare.gov/pubs/f_inter/index.cfm

adopted individuals and their families to need support 

beyond the initial transition period. For more information 

about postadoption services and their benefits, refer to 

Information Gateway’s Finding and Using Postadoption 

Services at https://www.childwelfare.gov/pubs/f_

postadoption.cfm. 

Additional Resources 

ChildWelfareInformationGateway.Includes several 

publications and web sections on intercountry adoptions, 

including the following:

 Adoption Options 

https://www.childwelfare.gov/pubs/f_adoptoption.cfm

 Obtaining Background Information on Your Prospective 

Adoptive Child

https://www.childwelfare.gov/pubs/f_background.cfm

 Children Who Spent Time in Institutions

https://www.childwelfare.gov/adoption/types/

intercountry/institutions.cfm

 Adopting Children From Another Country

https://www.childwelfare.gov/adoption/adoptive/

other_country.cfm

 After Intercountry Adoption

https://www.childwelfare.gov/adoption/adopt_

parenting/intercountry/index.cfm

 Transracial/Transcultural Adoption 

https://www.childwelfare.gov/adoption/adopt_

parenting/intercountry/transcultural.cfm

U.S.DepartmentofState. Provides information on a 

wide range of intercountry adoption topics, such as the 

Hague Convention, the adoption process, and countryspecific notes: 

http://adoption.state.gov/ 

U.S.CitizenshipandImmigrationServices. Details the 

Convention and non-Convention process for intercountry 

adoptions: 

http://www.uscis.gov/adoption

UniversityofMinnesotaInternationalAdoptionClinic.

Addresses health issues related to children adopted from 

other countries: 

http://www.iac.umn.edu/

AmericanAcademyofPediatrics. Includes a listing of 

pediatricians by State who specialize in providing services 

to adopted children and information about health-related 

adoption issues: 

http://www2.aap.org/sections/adoption/index.html

ComeUnity. Highlights information on health issues 

related to intercountry and domestic adoptions, including 

a list of clinics and doctors that specialize intercountry 

adoption: 

http://www.comeunity.com/adoption/health/index.html

CentersforDiseaseControlandPrevention. Provides 

information about health issues related to intercountry 

adoption, such as travel preparation, medical exams, and 

immunizations:

http://www.cdc.gov/travel/yellowBookCh8-Adoptions.

aspx

References

Adoptive Families. (n.d.). Cost of adoption update: 2012–

2013. Retrieved from http://www.adoptivefamilies.com/

articles/585/domestic-international-foster-adoptionexpenses-2012-2013

Child Welfare Information Gateway. (2009). Parenting your 

adopted preschooler. Retrieved from https://www.

childwelfare.gov/pubs/factsheets/preschool.cfm

Child Welfare Information Gateway. (2011). Costs of 

adopting. Retrieved from https://www.childwelfare.

gov/pubs/s_cost/s_costs.pdf

Child Welfare Information Gateway. (2012). Finding and 

using postadoption services. Retrieved from https://

www.childwelfare.gov/pubs/f_postadoptbulletin

Groza, V., Ryan, S. D., & Thomas, S. (2008). 

Institutionalization, Romania adoptions, and executive 

functioning. Child and Adolescent Social Work Journal, 

25, 185–204.

Hague Conference on Private International Law. (2008). 

The implementation and operation of the 1993 Hague 

Intercountry Adoption Convention: Guide to good 

practice: Guide no. 1. Retrieved from http://www.hcch.

net/upload/adoguide_e.pdf
Intercountry Adoption: Where Do I Start? https://www.childwelfare.gov

Johnson, D. E., & Gunnar, M. R. (2011). Growth failure 

in institutionalized children. Monographs of the 

Society for Research in Child Development, 76(4), 

92–126. Available at http://www.thinkchildsafe.org/

thinkbeforevisiting/resources/4_growth_failure_in_

institutionalized_children.pdf

Levin, A. R., Zeanah, C. H., Jr., Fox, N. A., Nelson, C. A. 

(2014). Motor outcomes in children exposed to early 

psychosocial deprivation. Journal of Pediatrics, 164, 

123–129.

Merz, E. C., & McCall, R. B. (2010). Behavior problems 

in children adopted from psychosocially depriving 

institutions. Journal of Abnormal Child Psychology, 38, 

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Miller, L., Chan, W., Comfort, K., & Tirella, L. (2005). Health 

of children adopted from Guatemala: comparison of 

orphanage and foster care. Pediatrics, 115, 710–717.

Nelson, C. A., III, Zeanah, C. H., Fox, N. A., Marshall, P. J., 

Smyke, P. T., & Guthne, D. (2007). Cognitive recovery in 

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Pinderhughes, E., Matthews, J., Deoudes, G., & 

Pertman, A. (2013). A changing world: Shaping best 

practices through understanding of the new realities 

of intercountry adoption. Retrieved from http://

adoptioninstitute.org/publications/a-changing-worldshaping-best-practices-through-understanding-of-thenew-realities-of-intercountry-adoption/

Reilly, T., & Platz, L. (2003). Characteristics and challenges 

of families who adopt children with special needs: An 

empirical study. Children and Youth Services Review, 

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Administration for Children and Families. (2014). 

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http://www.acf.hhs.gov/sites/default/files/cb/im1402.

pdf

U.S. Department of State, Bureau of Consular Affairs, 

Office of Children’s Issues. (n.d.-a). Statistics: Adoptions 

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about_us/statistics.php

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state.gov/about_us/statistics.php

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Office of Children’s Issues. (2013). Convention 

countries. Retrieved from http://adoption.state.gov/

hague_convention/countries.php

U.S. Department of State, Bureau of Consular Affairs, 

Office of Children’s Issues. (2014). FY 2013 annual 

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Zeanah, C. H., Smyke, A. T., Koga, S. F., & Carlson, E. 

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Suggested citation:

Child Welfare Information Gateway. (2014). Intercountry 

adoption: Where do I start? Washington, DC: U.S. 

Department of Health and Human Services.

U.S. Department of Health and Human Services 

Administration for Children and Families 

Administration on Children, Youth and Families 

Children’s Bureau