Survey Respondents. All 79 survey respondents participating in this study had relinquished their infants to adoption during the years 1965 and 1972. The mean age of the birthmothers was 50; ages ranged from 43 to 57 years of age. Their mean age at the time of giving birth was 19; ages ranged from 14 to 25. Responses were received from a total of 32 states within the United States.

Of the 77 responses received concerning whether the adoption was open or closed, 95% were closed adoptions. 67% of the birthmothers had been reunited with their child. 89% of these women were still in contact with the child. 28% of the respondents were single, divorced, separated, or widowed; 72% were married or living with someone. Of the 79 respondents, 27% did not have other children.

42% of the birthmothers had received psychotherapy because of the relinquishment; 67% of whom responded that psychotherapy had helped. 86% of the birthmothers had participated in birthmother support groups, of which 91% reported that it was helpful.

Post-Survey Discussion Group Profile. The post-survey discussion group was comprised of three birthmothers: Chris, Jarrett, and Terry. Their mean age was 50 years old. The mean age at the time of the birth was 18. One member was married with two kept children; one was divorced with one kept child; and one was living with someone and did not have other children. All had been involved in closed adoptions. All had been reunited with their children. Chris and Jarrett had both been reunited with their children for several years. Terry had only recently made contact and was preparing to meet with her son. One member of the group had been found by her child; the other two members had searched and found. Each of the birthmothers was currently in contact with her child. All three of the participants had received psychotherapy because of the relinquishment and had also participated in birthmother support groups. All participants were enthusiastic to participate in this study. For one birthmother, this was her first time meeting other birthmothers face-to-face.

Relinquishment and Traumatic Stress Symptoms. The birthmothers in this study overwhelmingly described their experience of relinquishment as traumatic. Responding to the statement "Relinquishing my child was a traumatic experience," 89% answered that this statement was "Extremely true;" 96% of the respondents answered either "Extremely true" or "Very true." The three positive responses combined ("extremely/very/somewhat true") accounted for 99% of the responses.

The mean scores for traumatic stress symptoms of intrusion, avoidance, and hypervigilance experienced since the relinquishment were 25.5, 25.8, and 18.3, respectively. For the assessment of posttraumatic stress disorder, Horowitz, Wilner, and Alverez (1979, cited in Fullerton & Ursano, 1997) assigned the following IES intrusion and avoidance clinical thresholds: less than 8.5 (low), 8.6-19.0 (medium), and greater than 19.0 (high). In this study, the total mean score for intrusion and avoidance was 25.7, and for the three subscales, 23.2. Since the instructions to the Impact of Event Scale questions were modified to measure the occurrence of symptoms since the relinquishment, rather than in the last seven days, the current study may not be valid for the clinical assessment of posttraumatic stress disorder. However, the birthmothers' responses indicated that the majority of the birthmothers reported experiencing one or more traumatic stress symptoms often. During the time period since the relinquishment, 87% experienced at least one or more symptoms of intrusion; 84% experienced at least one or more symptoms of avoidance; and 61% experienced one or more symptoms of hypervigilance.

Unresolved Grief, Depression, Guilt, Remorse and Shame. As found in previous studies (de Simone, 1996; Gediman & Brown, 1991; Lauderdale & Boyle, 1994), unresolved grief was common among the survey respondents. 95% of the respondents selected the "most frequent" or "most severe" response to one or more items measuring unresolved grief. In response to items concerning depression, 51% of the respondents reported experiencing severe depression since the relinquishment, with 97% reporting some degree of depression (mild, moderate, or severe). Over half of the birthmothers reported experiencing depression often since the relinquishment. 63% have had thoughts about killing themselves. 89% of the birthmothers reported experiencing feelings of guilt: sometimes (33%) and often (56%). Feelings of remorse were reported sometimes (34%) and often (58%), totalling 92% of the survey responses. The survey respondents reported experiencing shame sometimes (32%) or often (41%), totalling 72%, since the relinquishment.

Birthmother Syndrome. The survey responses for items measuring components

of Jones' (1993) "birthmother syndrome" and Carlini's (1992) "core issues of relinquishment" are presented in Table 1. Only the "most frequent" or "most severe" responses are included. The derivation of characteristics is described in Appendix H.

Statistics in Context. Table 2 contains all items for which more than 50% of the respondents selected an "extreme" response (i.e., "most frequent" or "most severe" or "not at all" response). These items formed the agenda for the group discussion.

"With-an-Agenda Counseling." Most of the respondents answered that they did not receive adequate counseling at the time of relinquishment. In response to the statement "I received adequate counseling at the time of the relinquishment," 94% indicated that it was not at all true and the remaining 6% indicated that it was somewhat true. The group unanimously agreed that any counseling provided was done so "with an agenda." The following excerpts reflected the group's experiences with relinquishment counseling.

__________

JARRETT: "There was not really any emotional counseling. . . .Don't make a mistake like one girl who decided not to give up her baby. . . .They pushed this girl off to the side and pointed at her as an example and said this girl is going to ruin her child's life. If she loved her child she would give him up. And don't make the same mistake that this girl is making. It was like don't even talk to her. She had to be shunned. . . .Having the group experience helped a little bit. You weren't the only pariah. We were a group of pariahs. . . . In my counseling, the general attitude was get on with your life. But you will get over this in a few years. This will all recede behind you and you will forget all about it. . . . Counseling was defined as a completely different thing in those days. Counseling was how to make you give up your child and not give them a lot of trouble about it. And then go away."

__________

TERRY: "I was in someone's home. There was another pregnant girl there. I had no counseling. . . I was basically warehoused. When I did see a therapist much much later, I had already gone through suicidal bouts, hospitalization. . . I think that what you mentioned earlier. . . society, the niche thing it was trying to fit us all into. . . was pretty phenomenal. As women we had certain things we were supposed to do. If we were not that person, we were a misfit. As a woman, we were a mistfit in society and as an artist certainly. . . this creative person. . . what was done to me... to try to fit me into a niche and try to take me away from what I needed for my creativity. . . no adequate counseling. I think it's only now that I'm getting adequate counseling."

__________

CHRIS: "The psychologist that my mother sent me to, I think I saw him maybe once a month. And he would just sit there for 50 minutes telling me that there's no such thing as maternal instinct. I bought into it. I mean I was seventeen. 'Oh. Okay.' I had seen him before I had gotten pregnant. . . so when I saw him after I was pregnant, I was like 3 or 4 months along. The first thing he said to me was, 'You know if you had told me about this, I could have gotten an abortion for you under the basis of it endangering your health'. . . I couldn't believe that he said such a thing."

JARRETT: "And his comfort to you at the end of the pregnancy was there's no such thing as maternal instinct?"

CHRIS: "Oh. It was constant. So I guess it was to combat anything, and so, of course, that made me feel like there was something really wrong with me."

__________

JARRETT: "The counseling I remember getting was, "If you love your child, you will give this child to deserving people as opposed to you. . . .

CHRIS: "With two parents too. . . to a father, to a mother."

JARRETT: "To nice people."

TERRY: "A real home."

JARRETT: "As opposed to you miserable creatures. . . That's the agenda thing."

CHRIS: "And then you get on with your life."

__________

The group's experiences concerning the adequacy of relinquishment counseling was consistent with the survey results. Their experiences suggested that the emotional needs of the birthmothers were not met by the counseling provided by psychologists or agency social workers. Rather, when available, counseling was viewed as a means to persuade birthmothers to relinquish their children to adopting couples. Several underlying assumptions were raised: (1) That the birthmother would keep her child only if she did not love him/her and would consequently ruin the child's life; (2) That relinquishing the child was an act of love; (3) That birthmothers were of less worth than the adopting couple; and (4) That after relinquishment, the birthmother would forget the experience and be able to resume a normal life. The group acknowledged "buying into" these assumptions at the time of the relinquishment, but now challenged their validity.

Traumatization. In response to the statement: "Relinquishing my child was a traumatic experience," 89% of the survey participants responded extremely true. In total, 99% responded that the statement was either extremely, very, or somewhat true. The group identified the following factors as implicated in experiencing relinquishment as traumatic:

Analysis of this question began with a discussion of the factors that might have accounted for the single "not at all true" response.

JARRETT: "I'm trying to figure out why people would answer not true. . . . I was told outright that I would be able to find my son again when he was 18. . . . And I know other people who were told the same thing. So I looked at this . . . of course it was very traumatic. Eighteen years is a long time, but at least there was an end. So if somebody was told that, that certainly would reduce the trauma. . . . "

__________

As facilitator, I presented the following question to the group: "What does relinquishment trauma mean to you?" Each of the members shared their perceptions and experiences:

TERRY: "It's a total shift of reality. . . . Everything you thought was, no longer is. . . .Women have been hiding from themselves for so long. It's almost like a shadow self. . . . There's the shell and the self. . . . It's disassociative. You're disassociated from yourself. You've disassociated from what you've experienced. You had to do that in order to continue and in order to be able to live, basically, to protect yourself. So you're disassociated. . . . If you have good things happen in your life, it's not really going to be good enough because it's not happening to you. . . . But there's always that certain sort of emptiness inside and it's not only connected to the loss of the child. . . . I think that even now there are still some women that this is a taboo, dirty, you don't count... you're not a full human being. You don't deserve the same consideration as other people. . . . You're a bad girl. And I think some of this still exists. A lot of people who are out there dealing with women who are thinking about relinquishing a child or adoptees are still products of that. You know they bought into it. They are still products of the same thing that traumatized us, of the same system, the same society. And I think society has a lot of garbage left over. . . . The relinquishment was one thing. I was so in denial of that for so long. I didn't really deal with it. But the shame. . . the shame and the secrecy are the worst -- the worst thing."

__________

JARRETT: "For me the sense of being violated and the sense of having been abandoned were probably the two strongest components of trauma. . . . It's having the child and then having the child ripped away. . . .When I was 29, my sister, who was ten years younger than I, was killed. . . And I felt, it was like I was the mother. I felt that loss as a mother would feel it, I think. I felt physical pain in my belly and I think that a lot of that was losing [my son] coming back to bite me. And I think that's when I started feeling the absolute need to search. . . .I thought that the loss of my son was the worst, much worse even than the shame."

__________

CHRIS: "You know I went through for many years thinking that I'd totally done the right thing. . . . I used to think I got through that experience so I could get through anything. . . . . How could a therapist, especially a woman who's ever had a child, think that to lose your child would not [damage us]."

Betrayal and Misinformation. 97% of the survey respondents indicated that the statement "I was either misled or not informed of the effects that relinquishment would have on me" was true. 85% of the respondents described it as extremely true. The following issues were identified by the group as contributing factors underlying this response or consequences thereof:

The experiences and perceptions of the group participants concerning this question follow:

JARRETT: "Everyone around us, whether we were in a home or not, wanted one thing - to separate us from our child. So everything they told us was colored by that. You will be fine. We will take your child. Your child will be better off. You're not worthy. . . .

__________

TERRY: "Did they care? Who was going to tell us? Who cared? They didn't care. . . . This is something that you will live with forever. . .

__________

CHRIS: "It's just hard to comprehend. It's hard for me. It's really mind-boggling. For our mothers who had children who knew the attachment that is possible with the child. . . . There's that other part of them that's a mother. How could they have ever done such a thing to their daughter. . . And it was always thinking about what's best for my daughter. And what's best for me too. . . . As a mother from a gut feeling, how could they imagine someone taking their baby from them?. . . I wonder if they could even have allowed themselves to think of that. . . . If someone had told me that this is probably what you are going to be feeling at some point in your life. This stuff is going to resurface and it may happen this way or that way. Just not knowing what was going on. With denial. With everything. Just feeling kind of lost. . . ."

__________

JARRETT: "We had no rights. . . . [I was misled about] the fact that I would be able to find him when he was eighteen."

TERRY: "Actually, we did have rights. In some states you had a certain period of time that you could say you wanted your child back. I was never told that."

CHRIS: "I called the agency after I got home from the hospital. And after I signed the papers, I don't remember how soon it was, but it was soon. It was like a day or two later, I called the agency. And I said I don't want to do this. I want her back. And they said it was too late. That she was in a foster home for a month. . . .[What has come around to me] is the anger at the agency, at the system that did this, at the society. . . .And what are you going to do with that anger? It's frustrating."

Intrusion. 95% of the respondents answered that "Any reminder brought back feelings about it" sometimes/often (22% sometimes, 73% often). The group participants had mixed responses to this question. Their experiences included denial, avoidance, and intrusion.

CHRIS: "I'd have to say no because I just stuffed it down so far. Even with having other children if I was reminded I wouldn't go there. I forgot her birthday. I couldn't remember her birthday. If you haven't been in that experience, someone could say how in the world could you forget your daughter's birthday."

__________

JARRETT: "Mostly it made me flee from reminders."

__________

TERRY: "Every year [on his birthday] I was really down with no one to share it with."

No Relief. Relinquishing my child was a great relief.

Regrets. I have no regrets about relinquishing.

These two items were discussed simultaneously. For each, 73% of the respondents answered that these statements were not at all true. The group wanted to follow up on the 27% that responded that relinquishment was a great relief or that they had no regrets. They considered whether denial was a factor. They suggested that if the birthmothers saw that their child went to a good home and felt that they were unable to provide it, then there might be feelings of relief or no regrets. However, for the group participants, these statements were not at all true.

Grief. Since the relinquishment, I experienced grieving for the loss of [my] child. 71% responded that they grieved for the loss of their child often. The group members raised the following associations to this statement.

The experiences and feelings of the group members supporting these associations follow:

JARRETT: "I think we grieve still even after reunion. But the grieving thing, that really is true. And it's partly because we were never given permission to grieve back when it was time to. We were never given support of any kind whatsoever. And our child was not dead. Our child was out there somewhere. We couldn't even be at peace with their being wherever we imagine dead people being. . . .It's like acid in your stomach. I spent weeks sitting in the middle of my queen size bed howling -- like baying at the moon, howling with grief. . . . But now that I've found my son I still grieve . . . in the same way over different things. . . about having lost all those years. . . about not knowing what his favorite foods are. . . .like he's a guest. . . . like not having him know those things about me. . . about my guilt that I did this to him. . . about his anger. . . grieving. . ."

__________

TERRY: "We weren't allowed to share. I certainly didn't share. I only shared it with men I was with. . . . I started to tell women friends about it very slowly. There were people I knew for years who didn't know. Suddenly as I got closer to searching, I started to tell more people. There was no hope that you would be able to share it with anybody. . . . You're isolated with the pain."

Language. As facilitator, I asked the group if they could identify how the use of language may have influenced the relinquishment experience. Several themes emerged:

The terms "unwed mother" or "out-of-wedlock" were viewed as patriarchal and stigmatizing. The group also felt uncomfortable with the terms used to differentiate birthmothers from adoptive mothers. The language used to describe the relinquishment, such as "relinquished, gave up, surrendered," were imbued with a variety of meanings. The term "lost to adoption" was identified as best describing their experience.

On Shame. Shame was a predominant theme throughout the discussion and surfaced as a major player in affecting the relinquishment experience. The following comments portray the underlying assumptions surrounding the group's experience of shame and its effects:

CHRIS: "There is this stigma, you weren't even good enough for him to marry. . . . Or you made such a bad choice of fathers. . . . While I was pregnant living in this house with my mother, she never talked about my pregnancy... It was like there's a pumpkin in your stomach or something. You'd better take care of that. It was like totally nothing about how it was like when she was pregnant. . . . We're just going to keep going on like nothing happened. You'll go into the hospital and then it'll be over with."

__________

[Jarrett was the only group member who had held her baby after he was born. Terry was not permitted to hold her baby and recalled begging the nurses to permit her to see him through the nursery window. Chris neither held nor saw her daughter.]

__________

CHRIS: "I asked the doctor if I could see her and he said yes. . . He said he'd tell the nurses. . . And I was like this very wimpy kid and I asked the nurses and they said 'Oh, in a little while.' And they just kept putting me off and putting me off. . . . As soon as I got pregnant and I had like brought this shame on the house, they could do anything to me. Because this was the punishment... So don't rock the boat, Chris. . . .They didn't say that. . . But that was the message I got. . . .Even if I had had rights which I probably did at 18 when I had her, but I don't even think it crossed my mind. . . . We had a commodity. . . . I think the commodity was a very big thing. I don't think it started out that way, but I think that's what it turned into."

__________

JARRETT: "I definitely had the feeling that I had brought all this horrible shame on my parents and at this point they were going to take over. I'd done quite enough . . . and I should just get out of the way. . . . [There was] denial of the pregnancy. Denial of the relinquishment. Denial of all the emotional stuff. . . . I remember as a sophomore or junior in high school, the minister asked me if I would come visit a girl who was living with him because she was friendless from out of town. And she turned out to be a pregnant girl who was stashed at his house and locked upstairs and she lived in his bedroom upstairs. She had no social life. She wasn't allowed to go out. . . .

I felt so sorry for this creature. If it's bad enough to get locked up over it, it's pretty shameful."

__________

TERRY: "[The focus was on] "Why did you allow this to happen to you? . . .Instead of trying to explore what we were feeling about ourselves. . . .I think we had models of other women who had come before and been shameful. I mean in my town there were the bad girls and there were the good girls. And the bad girls, a lot of them ended up pregnant out-of-wedlock and they were sluts. So of course I was a slut, or I would have been if I had been in that town. So my parents just simply hid me away somewhere. So I think that they were trying to protect me. They were also trying to protect themselves. But they were trying to protect me in the only way that they knew how. . . You couldn't talk about it. My sister didn't know. My two brothers didn't know. No one in the family knew except my mother and my father. And I only told [my family] last year, at Thanksgiving dinner. . . . So shame has been such a driving force in my life."

__________

The group was presented with the survey finding that 41% of the participants had received a hysterectomy and were asked how they interpreted that.

CHRIS: "I never had any problem. I went in for my checkup and then about four months later, this was right at the time of the reunion. About six months into the reunion, then I started to develop all the symptoms of fibroids. And because they grew so quickly and because they were so large they said we'd just better take this out. Because it just was too quick and then my therapist said think about this. Think about this timing because you don't have a history of this in your family. And talk about the mind and body connection and that that's where it decided to plant itself."

__________

JARRETT: "It comes back to that physical feeling that I had at the death of my sister. In my belly. In my womb. It was being like torn away, that tearing away."

__________

In this section I have presented the summarized data from the survey and have drawn from the interpretations, perceptions, and insights provided by the discussion group for greater depth. I have attempted to present the relinquishment experience as an intricate tapestry woven together by the threads of data emanating from the survey responses. In the next section, the implications of these results are discussed and considerations for social action, clinical counseling and future research are presented.