Though the adoption is official and permanent after placement and the legal termination of parental rights have occurred, the birthmother will not ever forget or cease to be affected by the adoption process. Even when there is virtual certainty that adoption was the right thing to do, it remains a difficult and emotional process for many birthmothers; one that may affect them for many, many years down the road.
First, there can be ongoing grief feelings that birthmothers feel over the loss of their child. Even when initial grieving has been completed, grief may re-surface and be felt rather acutely during "anniversary" periods (e.g., the child's birthday). Birthmothers in semi-open or closed adoption may grieve their loss of ability to share in their child's significant life events.
Birthmothers in open adoption arrangements may also have difficulty, for while they may be present at these special events, they are not acting as the mother of the child, but instead as more of a close friend or extended family member. They may grieve the loss of that closer relationship that "could have been" with the child.
However, grief accompanying closed adoptions may be made a bit lighter as the mother thinks about the opportunities and positive life experiences that the child has likely received with the adoptive family. In the open adoption, the birthmother has the added benefit of being able to see first-hand the joy, happiness and opportunities that have been given to the child by the adopted family and realizing that she made it possible by choosing adoption over other options while pregnant.
Birthmothers' future partner or spousal relationships may also be impacted by adoption. The birthmother must decide whether she will discuss her adoption decision with a future partner or spouse and (in an open adoption circumstance) what role that partner will have in her ongoing relationship with that adopted child. Whether or not to tell partners about a past adoption can be a difficult decision to make, as birthmothers may fear partners' judgments or blame. Birthmothers must also decide whether to share information concerning the adopted child with any future children they may go on to have, and then (in an open adoption circumstance) to help shape what relationship those children might have with their adopted half-brother or sister. To further complicate matters in an open adoption circumstance, the wishes of adoptive parents and children must also be weighed and considered when birthmothers are making decisions about whom to tell and what relationships will exist. The web of tangled relationships can become difficult to navigate. Access to counseling and support groups, on an as-needed basis, may benefit birthmothers who struggle with such issues.