Obstetric History and Adoption

In thinking about my previous post on gravidity and parity (how many times a woman has been pregnant and given birth), I was made to think about a woman I know of — a beautician where my mom gets her hair done. This woman had several miscarriages before finally making it to term once (for the purposes of this post, I’ll assume she had 4). The baby had several congenital defects and died a few days after birth. A few months after that, the couple adopted twins who were born a few weeks premature.

Obstetrically speaking, the woman is G5P1A4, or G5P1-0-4-0 (five pregnancies, 1 birth at term, no preterm births, 4 miscarriages, no living children). But legally speaking, she is the mother of twins. Although I don’t know anything about the birth mother, in obstetric terms, she is probably a G1P1, or G1P0-1-0-2 (1 pregnancy, no term births, one preterm birth, no miscarriages, two living children). But legally speaking, she has no children.

Another friend of mine’s husband is sterile, so they don’t have biological children; she’s a G0P0. But they were able to adopt a baby, so they have a child. The baby’s biological mother is a G1P1 or G1P1-0-0-1… except she hid her pregnancy from everyone including her family, and no one knows she ever had a baby. She had an elective C-section (to avoid going into labor or having her water break, and letting the secret out), and lied to her family about needing to have some other surgery done, to cover for her surgery and recovery. Her family assumes she’s never been pregnant, never had a baby.

I don’t know much about the ins and outs of adoption. One thing I do know is that when someone is adopted, the information is changed on the birth certificate to match the family’s legal standing, whether the child was adopted as a newborn or an older child. My friend and her little brother were adopted by her mother’s second husband when they were 12 and 2 years old; their father’s information was removed from their birth certificates, and their stepfather’s name was put in. One person whose blog I keep up with recently adopted a baby in an open adoption, and the adoptive mother was a little perturbed that there was no mention of the baby’s biological family on the birth certificate, because she is very much of the opinion that the birth parents should be mentioned and acknowledged, at least in her situation. But, legally, they are not, and I suppose they have no rights whatsoever. The family gave the child up for adoption because they were struggling to make ends meet, with the children they already had. They had also previously given up a child. She should be G4P4, or G4P3-1-0-4 (the last baby was born preterm)…but since they legally only have two children, I don’t know if that changes anything.

Someone else commenting on that blog said that she was adopted before her mother had any biological children, so she was listed as her mother’s firstborn on the birth certificate; and then when her mother gave birth to a daughter after the adoption of her first daughter, and that baby was also listed as her mother’s first-born. Obstetrically speaking, she was; legally speaking, she wasn’t.

So, things can get a little sticky sometimes.

I wonder how this might play out in statistics — especially neonatal and infant mortality. When looking just at birth certificate data, if an adoptive mother and father are listed as the child’s parents (which they legally are, but for purposes of biology, they aren’t), I wonder how much information is actually carried over? On my birth certificate worksheet, as well as the ones I filled out for my children, there was a lot of information about both myself and my husband — our age at the time of birth, where we were born (city, county, state), occupation, education, race, etc. There were also health factors about me (I think my height, prepregnancy weight, and weight gain were all noted, and possibly other factors). Both the mother’s and the father’s ages are factors in the risk of certain conditions, especially genetic disorders like Down Syndrome. If researchers look at birth certificate data — which would list the adoptive family’s information — might they be getting an incorrect picture?

Of course, most babies aren’t adopted, so any skewing of the data might be slight; and I would assume that for the purposes of research, any known adoptions would be excluded… but how would they exclude them when just looking at birth certificate data? However, as I said before, I don’t know just too much about the paperwork of adoption. However, my friends I mentioned above are both Caucasian, and the baby they adopted is Hispanic, or at least, the mother is Hispanic… the father may be too. The adoptive mother is short and thin; the biological mother was tall and big (which is how she was able to conceal her pregnancy from everyone). The baby has always been big for his age, and is now wearing almost the same size clothes as my 4-year-old, although he’s a few weeks younger than my two-year-old. There is great genetic disparity between the child’s adoptive and biological families, and since statistics are kept by race, I wonder how these things work. I must admit, part of me gets a devilish sense of glee at messing with the minds of bean-counters — a Hispanic boy born to two Caucasian parents; when he gets older, he’ll probably be 6’2 and weigh 250 lb., bigger and taller than either of his parents. That doesn’t fit within the narrow confines of genetics! 🙂

And then you’ve got embryo adoption, in which parents legally adopt another couple’s embryos (after the other couple has had all the children they want through IVF), so the adoptive mother actually gestates and gives birth to a baby that is not genetically her own — kind of like a surrogate mother, except instead of just gestating for another women, she is gestating another woman’s fertilized eggs, for her own baby.

So, variations I see that might delightfully mess with the whole “nature vs. nurture” question because things don’t fit into neat little boxes:

  • a couple adopts a child genetically similar to themselves (same race, perhaps even same ethnicity or ancestry — like my aunt and uncle who are both full-blooded Dutch Americans did, in deliberately requesting a baby born of a Dutch-American mother)
  • a couple adopts a child genetically different from themselves (crossing racial lines completely, as in a Caucasian couple adopting an African child; or partially, as in a Caucasian couple adopting a mixed-race child; or partially, as in a mixed-race couple adopting a child completely of one or the other race; or completely, as in a mixed-race couple adopting a child from a different race entirely)
  • a woman becomes a surrogate mother for a couple, being impregnated with their biological child
  • a woman becomes a surrogate mother for a couple, not being impregnated with their biological child
  • a couple adopts embryos, so that the woman becomes pregnant with another couple’s biological children

Wow — think of all the factors that might go into play in all of these categories! Bean-counters are used to white parents having white children, and black parents having black children, and bi-racial couples having bi-racial children; but white parents having black children just doesn’t fit into a neat little pigeon-hole! I can see a reason to note racial factors, but sometimes I get the idea that people are pigeon-holed by their race, and rather than it being a help, can be a hindrance. I’ve seen attitudes of fatalism in some people, that, “Oh, well, we just can’t help these mothers and/or babies, because they had this or that risk factor…” I don’t like that! Ok, stopping myself before I go off on a tangent, here!

But, really, when thinking of how much genetics and maternal health goes into things related to pregnancy, birth, and the first year of life, it really does get to be a lot of food for thought. First, is the baby’s genetics, then the gestating mother’s genetics, and finally the gestating mother’s current state of health. When a woman carries a child that is not biologically hers, how much of the child’s biology goes into the pregnancy, and how much of the woman’s biology, and the woman’s health, go into the pregnancy? Is it possible that there are some fetal considerations that go into certain maternal health conditions — like gestational diabetes, preeclampsia, or preterm birth? I can easily see it be so — the mother’s body adapting to the life within, even if not genetically her own. Not genetically her own, but biologically her own, since it was her body gestating the baby?

Ok, I’m making my own brain hurt, trying to think of all the considerations, so I’ll stop rambling now. 🙂


4 Responses

  1. Couldn’t help noticing your blog, so I hope you find this link of interest >



  2. You made a couple of errors which I feel I should point out.

    You wrote: “Obstetrically speaking, the woman is G5P1A4, or G5P1-0-4-0 (five pregnancies, 1 birth at term, no preterm births, 4 miscarriages, no living children). But legally speaking, she is the mother of twins.” No, she has no children.
    Then you wrote “Although I don’t know anything about the birth mother, in obstetric terms, she is probably a G1P1, or G1P0-1-0-2 (1 pregnancy, no term births, one preterm birth, no miscarriages, two living children). But legally speaking, she has no children.”. Incorrect. Legally speaking, she is the mother of twins.

    • The adoptive mother is the legal mother; the birth mother is not the legal mother — she gave up her rights when she signed the paper releasing the child(ren) to be adopted, and/or when the adoption was finalized.

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