International Adoption and Related Healthcare Issues

Lucky parents receive thorough medical records for their child; often, however, the details are sketchy at best. Michele Seidl and Neil Shubin of Chicago consider themselves in the "lucky parent" category. The information about their son in Korea, Nathaniel, included two photos, and not only the basic vital statistics and other medical information, but also background on his biological parents, and a behavioral report from a social worker who spent time with Nathaniel. "It didn’t feel like a lot of information to us, but for an international adoption, it was a goldmine," says Seidl.

Seidl and Shubin took the photos and information to Larry Gray, M.D., Dr. Kim’s associate at the International Adoption Clinic at the University of Chicago Children’s Hospital, for a pre-adoption assessment. Dr. Gray spent two hours plotting Nathaniel’s length, weight, and head circumference on both Korean and American growth charts and poring over every line of the medical report with Seidl and Shubin.

"The medical terms used internationally are different than those used in the U.S., and many pediatricians may not be familiar with them," says Heidi Schwarzwald, M.D., M.P.H, an assistant professor of pediatrics at Baylor College of Medicine, who currently works at Botswana-Baylor Children’s Clinical Center of Excellence in Botswana. "That is why it is important to have a specialist review the records." Pediatricians who specialize in internationally adopted children can translate the child’s record for parents—and even begin to create a parent-child bond.

One detail in Nathaniel’s record that Dr. Gray picked up on was a note that the baby stretched his legs flat when massaged. In translating what that could mean, he told Seidl and Shubin it could be an indication of cerebral palsy. Or, he noted, it was likely to be a cultural difference in the way children’s reactions and reflexes are described in Korea. "It was pretty scary, but it also was the moment we realized, ‘This is our child,’" says Seidl. "It was a powerful experience." Nathaniel, whom Seidl and Shubin adopted when he was four months old in May 2002, is the picture of health.

It's Difficult Not Knowing

Paul and Andrea Rupple of Chicago were at the other end of the information spectrum when they adopted their daughter, Renee, from China. They knew nothing about Renee’s birth parents—they weren’t even sure if her birthday was the right one. A one-page medical report listed vital statistics, but not much more.