"Birth mothers" are women who have surrendered their babies for adoption. They have often experienced excruciating and recurrent pain. It is not unusual to hear these women say, "I'll never get over it," "I think of my child frequently," or "I'll never forgive myself."
Many women who have surrendered a child are plagued by low self-esteem and mood disorders. Having given up a child for adoption is perceived by many birth mothers as negatively influencing marriage or partnership and parenting. It remains an overriding issue of conflict and intra-and inter-personal difficulty years later.
It can be expected that a woman who surrenders a child for adoption will experience sadness and loss. These women are more likely to turn grief and loss inward to depression that outward in the expression of anger. Four characteristics commonly identified with their depression are: vulnerability to loss, inhibition of action and assertion, inhibition of anger and low self-esteem.
If we recognize that the birth mother's difficulties in coping with the consequences of having surrendered a child for adoption are intimately linked to women's development in a sexist society, we must then ask how mental health professionals can work with women to enable them to feel more empowered to cope with these issues.
The therapist needs to support, encourage and participate in the active and multifaceted bereavement process of the client. The birth mother grieves not only for the loss of her child, but often for the loss of self-esteem, the loss of support from significant others, and the loss of her expectation about what her life would otherwise be like.
The relationship between the birth mother and her child does not end when she surrenders it for adoption, and the grief and bereavement of the birth mother is an ongoing process. Major events in the birth mother's life (marriage, birth, death, Mother's Day, menopause, etc.) or major events in the child's life (birthdays, starting school, reaching the age of 18, etc.) may rekindle the sorrow. Although the birth mother may not actually know the significant events in her child's life, she may have fantasies about these events.
In order to grieve, the woman needs to remove the shroud of denial and secrecy concerning the birth and surrender. Often this occurs for the first time within the safety of a caring therapeutic relationship, in which the birth mother is encouraged to talk about her expectations and her ongoing relationship with her child.
To alleviate the birth mother's distress caused by issues of grief, shame, guilt, and anger, it is essential that the birth mother enter into a caring, empathetic, and mutually empowering therapeutic relationship. This relationship will provide the opportunity for her to see herself as a person who is capable of giving, of nurturing, and of "mothering" herself and others.
