This excerpt, which describes one leading agency’s thinking about infertility in the early 1940s, reveals several things. First, limiting adoption to infertile couples was closely connected to a shortage of the children in greatest demand: healthy, white infants. Second, professionals thought differently about different kinds of infertility. They contrasted childlessness due to “organic” causes with childlessness that was inexplicable, sometimes called “psychogenic,” and therefore suspicious. Third, the agency concluded that couples who cooperated fully with requirements that their infertility be medically verified were more likely to suffer from “organic” infertility than couples who did not. This turned compliance with agency rules into a barometer of emotional adjustment and good parenting potential that was as important, in its own way, as infertility itself.

Through the month Mrs. Brenner had been interpreting to new applicants that there were few babies to place in proportion to the number of families who were interested in adopting children and that we were therefore requiring medical procedure to determine whether or not families might be able to have children of their own. We were explaining to families that we were not in a position to place a baby in a home where the family might be able to have its own child. . . .

We then went on to a consideration of those situations in which applications had been withheld pending our handling of getting medical information. The first group to be considered was the thirteen families who did not get in touch with us after the interview to give us permission to go ahead in contacting their doctors. In the first of these situations, the husband was in the Army. The family had been married for three or four years and had been given assurance by their obstetrician that they could have their own child. In the second of these situations the family seemed to have the feeling that it would be possible for them to have their own child. In the third case, a woman had come in to apply and a very close friend of hers had been applying to the agency at the same time. Both this applicant and her friend had displayed a peculiar feeling of pressure that something must be done for them in particular. . . .

We then went on to discuss the ten situations in which applications had been withheld pending medical routines and in which the families had been in touch with us so that we had procured medical information from their doctors. In the first of these situations the woman had had a series of miscarriages and the doctor indicated that there was a glandular condition and that he advised the family again[st] attempting to have a child. The next situation was one in which the family had originally written for an appointment on 10/28/42 and had not kept that appointment. They had come in again after arranging an appointment in December. In the interim period they had been able to get a baby privately. The baby had turned out to be a congenitally sick child who had to be returned to its parents. In the third of these situations, the prospective adoptive mother had never menstruated. The next family had presented a situation in which the couple had lost their own baby five years ago when he was seven months old. . . .

Our discussion of these two groupings, that is the families who had communicated with us to give us permission to get in touch with their doctors and those families who had not been in touch with us following the intake interview appointment for this purpose resulted in the following thinking: Dr. Bernard pointed out that there were certain common denominators in each group. It did seem that those families who had gone through with our procedure around procuring medical information presented situations in which there did seem to be more definite organic basis. In addition to this it seemed that they did have doctors who had pretty much let them know that they were not able to have children and had committed themselves to approving adoption for these families. They had had definite dramatic things happen to them, such as a number of abortions or the woman had not menstruated. The additional factor was that the doctor was an ally in these situations. They knew that their doctors would help them in their plan to adopt a child. Their inability to have a child was something which had already been emotionally accepted by them.

In the second group, that is those families who had not been in touch with us following the intake interview it did seem that their reasons for wanting to adopt a child were somewhat vaguer. In many of these situations the families seemed almost afraid of getting a definite answer from their doctors and did not know whether or not in approaching their doctors about adoption they would find him to be an enemy or an ally. The question developing out of this was whether this second group of families were people whose homes we would not want to use on the basis that they could not work this through for themselves. It was Mrs. Brenner’s thinking that there were certain evidences of maladjustments in those families who did not get in touch with us to signify their interest in our going through with the medical routine.

We all agreed that some sifting process had been necessary in view of the large numbers of applications and our inability to use a good proportion of these homes and we discussed at this point whether this particular procedure seemed to be the most desirable one.

In thinking through the desirability of this procedure it did seem that it offered an advantage in that those people who went through with the medical procedure by and large had more organic basis for their inability to have a child and were therefore less likely to be emotionally maladjusted. They would be more maternal and could transfer their feeling to an adoptive child more easily. . . .