These informal notes that Hutchinson used for teaching and consulting suggest the centrality of infertility to adoption home studies by midcentury.

1. The quality of the marital relationship.

2. The quality of relationships with family and friends.

3. Functioning of husband and wife in all areas.

4. Reason for childlessness.

5. Degree to which couple have worked out trauma of infertility.

6. Effect of infertility on the marriage—emotionally & sexually.

7. Way couple have handled their frustration & disappointment—mutual supportiveness or destructiveness)

8. The emotional climate the child must grow in.

9. Reasons for wish to adopt...conscious—unconscious—feelings—fantasies—

10. How much discussion bet. Parents prior to adoption—how much thought given to parenthood as well as adoptive parenthood.

11. How much medical exploration has been done.

12. How were plans to adopt shared or not shared with family & friends. (inability to do so often reflects inability to accept infertility.)

13. Feelings of couple re: discussing adoption with the child.

14. Adjustment to sterility

15. Need to consider that often defenses are built to handle feelings about sterility. The reality of the adopted child can serve to break down the defenses. This can be destructive to the individual and/or the relationship.

16. Can the couple, as parents, identify with an adopted child. This is present with a biolog. child—but can it be with one born of another. Can they really consider the child theirs.

17. Can they relate to a child according to the child's needs rather than out of their own conflicts.

18.An unrealistic concern over heredity can reflect basic question as to whether the child can ever really be theirs.

19. Are they threatened by an O.W. child. What are attitudes in this area. Can reflect their own unresolved fears and conflicts about sexuality. The adopted child reactivates and intensifies this. They worry about the child as a potential delinquent—a source of trouble—shame—. This relates also to acceptance of a child not born of them. Places blame for potential failure outside of themselves.

Conflicts involved in Adoptive Parenthood

1. Inability to have a biological child—a narcissistic blow. Infertility of wife threatens adequacy as a woman. Infertility of husband threatens maleness—Stillbirths & miscarriages threatens mothers potential as a parent—it is as tho she kills the child. When bearing physical or mental defectives—threatens also. As tho mother injures the child—cannot produce a normal child. Will she be able to help child grow normally.

2. Accepting a child as one's own who is conceived, born & surrendered by others, usually strangers. These problems can threaten not only the individual but also the marital relationship. Can precipitate resentment & antagonism of the partner deprived of child. Emotionally mature people work thru the impact of the infertility. Emotionally mature people can bring capacities for parenthood to Adoptive parenthood. If no adjustment to sterility, adopt. child will only be symbol of the parents frustrations—their feelings of inadequacy—of their failure.