The process of international adoption has three main parts: finding a child, getting custody of the child, and bringing the child to the United States. Your child must have a medical exam in the country he or she is from (the host country), in order to get a resident visa (an official form that says your child can legally live in the United States). The medical exam your child gets in the host country may or may not be complete. You shouldn't automatically trust that this exam reflects the health or illness of your child. However, your child will not be able to get a visa until all requirements have been met.

Will my child be ill on arrival in this country?

Most adopted children arrive in good health. It depends on the country they come from. It also depends on the surroundings they've been living in. One half of all adopted children usually have common illnesses (such as ear infections) that need treatment in the first month after they get here.

Will my child need to have a physical exam right away?

If the child has no obvious illness, it's often good for you to wait two to four weeks before his or her first visit with your family doctor. This will give you and your child time to get to know each other a little better. It will give you time to watch the child and look for any problems he or she may be having. At the first doctor's visit, your child will have both a physical exam and a set of screening tests that will help the doctor see any hidden problems. Of course, it may take more than one visit to find and treat some problems.

Does my child pose any risk of infection to others?

Children adopted from other countries do have a higher rate of infectious diseases such as tuberculosis, parasites and hepatitis B. It's a good idea to make sure your family's vaccinations, such as hepatitis B, are up to date before your child arrives. (Some vaccinations take six months to complete.) Many of the common infections (like parasites) are easily treated or aren't easily given to other people. Even though there is a higher rate of infections in children adopted from other countries, your family shouldn't be at risk during the first few weeks.

How much can we find out about our child's health history?

Any medical information you get from the host country is helpful, but sometimes the information isn't available or isn't complete. One way to find out about a child's well being is to ask the foster care or orphanage workers if they see your child as being any different from other children who are the same age in the same situation. A history of alcohol or drug abuse in the child's mother can be another clue to potential problems, such as fetal alcohol syndrome.

Will there be any surprises at the first visit to the doctor's office?

It's possible. However, serious medical problems, such as seizures or mental retardation, are rare. Often children will need immunizations (“shots”), hearing or vision aids, dental work and better nutrition. Watch your child's development over the first three months. You may find that with better nutrition, direct attention and love, your new child will grow quite a bit.

Additional Resources

To learn more about international adoption, you can contact the following organizations:

• Adoptive Families of America (AFA)

  2309 Como Ave.

  St. Paul, MN 55108

  Telephone: 1-800-372-3300, (651) 645-9955

• International Concerns for Children (ICC)

  911 Cypress

  Boulder, CO 80303

  Telephone: (303) 494-8333