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Encyclopedia of Health and Medicine

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242 The Reproductive System<br />

As a matter <strong>of</strong> course many adoptive families have<br />

the child undergo a comprehensive medical examination.<br />

Children adopted from other countries<br />

<strong>of</strong>ten have parasitic infections <strong>and</strong> other health<br />

conditions uncommon in the United States. FETAL<br />

ALCOHOL SYNDROME, congenital INFECTION with SEXU-<br />

ALLY TRANSMITTED DISEASES (STDS), HEPATITIS, RICKETS,<br />

TUBERCULOSIS, <strong>and</strong> hearing loss <strong>and</strong> VISION IMPAIR-<br />

MENT are also common, especially with international<br />

adoptions. Though these are <strong>of</strong>ten treatable<br />

conditions, they do require prompt medical attention.<br />

Children older than one year may have emotional<br />

<strong>and</strong> psychologic problems as well.<br />

Sometimes, even in a closed adoption, the intermediary<br />

(adoption agency or attorney) is able to<br />

obtain more specific health information about the<br />

child to pass onto the adoptive parents. Conditions<br />

that require ongoing care, such as fetal ALCOHOL<br />

syndrome or developmental disabilities, are special<br />

needs.<br />

Placing a Child for Adoption<br />

Women have varying <strong>and</strong> <strong>of</strong>ten deeply personal<br />

reasons for placing their biologic children for<br />

adoption. Common reasons for being unable to<br />

retain parental rights include<br />

• serious DRUG or alcohol abuse problems<br />

• extreme youth or immaturity<br />

• pregnancy that was the result <strong>of</strong> rape or incest<br />

• health or disability issues that prohibit properly<br />

caring for a child<br />

As well, mothers sometimes ab<strong>and</strong>on their children<br />

without known reason. A woman who<br />

desires to place her child for adoption can notify<br />

her doctor, a community service agency, an adoption<br />

service, or an attorney. Typically there are no<br />

expenses to the relinquishing parent. Depending<br />

on circumstances the biologic mother may choose<br />

the adoptive family, especially if she is pregnant at<br />

the time she makes the decision to place the child<br />

for adoption.<br />

The decision to place a child for adoption,<br />

which on the surface may appear straightforward,<br />

has lifelong emotional consequences for mother<br />

<strong>and</strong> child. The mother may feel guilty for “giving<br />

up” her child. The child, when old enough to<br />

underst<strong>and</strong> what adoption means, may feel ab<strong>and</strong>oned<br />

regardless <strong>of</strong> the circumstances <strong>of</strong> the adoptive<br />

family. It is important for adoptive families to<br />

be loving yet as open as possible about questions<br />

adoptive children may ask. Many communities<br />

have SUPPORT GROUPS for adoptive parents, adopted<br />

children, <strong>and</strong> people who placed their children for<br />

adoption. Support groups can help people share<br />

their concerns, feelings, <strong>and</strong> solutions to common<br />

problems.<br />

Parenting <strong>and</strong> family are life experiences that<br />

have challenges <strong>and</strong> accomplishments, perils <strong>and</strong><br />

joys, no matter what their configurations. For<br />

many adults who adopt, adoption brings to<br />

fruition a lifelong dream to raise <strong>and</strong> parent a<br />

child, either starting or adding to a family. And for<br />

many children who are adopted, adoption is daily<br />

evidence that someone wants them <strong>and</strong> loves<br />

them very much.<br />

See also CULTURAL AND ETHNIC HEALTH CARE PER-<br />

SPECTIVES; GESTATIONAL SURROGACY; PARENTING.<br />

aging, reproductive <strong>and</strong> sexual changes that<br />

occur with The reproductive system, male or<br />

female, is intact but immature at birth <strong>and</strong><br />

remains immature until the onset <strong>of</strong> PUBERTY<br />

around age 12. Researchers do not know what<br />

triggers the physiologic events that take place to<br />

initiate reproductive <strong>and</strong> sexual maturity. However,<br />

these events result in the development <strong>of</strong><br />

SECONDARY SEXUAL CHARACTERISTICS, sex drive <strong>and</strong><br />

interest, <strong>and</strong> the ability to produce new life. Male<br />

FERTILITY extends from puberty to the end <strong>of</strong> life,<br />

though may diminish somewhat in late old age.<br />

Female fertility is finite, starting at MENARCHE (the<br />

onset <strong>of</strong> the MENSTRUAL CYCLE) <strong>and</strong> ending with<br />

MENOPAUSE (the conclusion <strong>of</strong> the menstrual cycle).<br />

Only for a few days each month is a woman capable<br />

<strong>of</strong> CONCEPTION.<br />

The hormones <strong>of</strong> sexual <strong>and</strong> reproductive<br />

maturity have numerous <strong>and</strong> far-reaching effects<br />

in the body. Men <strong>and</strong> women alike have the spectrum<br />

<strong>of</strong> sex hormones: ESTROGENS <strong>and</strong> ANDROGENS.<br />

Androgens dominate in men; estrogens dominate<br />

in women. These hormones account for secondary<br />

sexual characteristics <strong>and</strong> reproductive ability as<br />

well as MUSCLE mass <strong>and</strong> STRENGTH, BONE DENSITY,<br />

lipid metabolism, aspects <strong>of</strong> cardiovascular function,<br />

cognitive clarity, BRAIN function, mood, <strong>and</strong><br />

emotion.

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