Last updated/verified: December 21, 2005
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Birthparent Questionnaire |
You can read the questionnaires, but any responses you make will not be recorded. This page is the birthparent questionnaire. You may view the adoptee questionnaire at: Adoptee Questionnaire.
The results have been completed and may be found at: Project Summary, as of February 2000.
For more information on the project see: Senior Research Project.
This research is only for reunited birthparents and adult adoptees of stranger adoptions, including those who hold more than one position in the adoption triad. To keep from constructing complex questions the questionnaire is divided between adoptees and birthparents. The questionnaires differ in only that the questions are asked from the appropriate perspective, and not in the intent of the questions. There is one questionnaire for adoptees, and one for birthparents. If you have more than one position in the triad, please, submit separate questionnaires. One questionnaire should represent one position in the triad and one reunion. This is the birthparent questionnaire it concerns your reunion with a child you lost to adoption. If you have had more than one reunion, you may complete this online questionnaire more than one time. If you are an adoptee, you can find the adoptee questionnaire at: Adoptee Questionnaire. If you would rather complete a paper copy of this questionnaire you may print a copy of it here: Print Copy.
Individual questionnaires will not be viewed by anyone other than the researcher and George Fox University faculty advisors on this project. If you want a summary of this research, you may request a copy at the end of this questionnaire.
Instructions: Answer all of the questions. Very few of the questions will not apply to you, when they do not apply, chose N/A. The choices may not exactly represent your feelings, but choose the response closest to your feeling. Some of the questions may seem redundant. However, in the test questionnaire, people felt asking the question in one way was not adequate. There is a place at the end of the questionnaire for additional comments.
Measuring satisfaction: What is your satisfaction level? If you feel you are satisfied, you are satisfied, regardless of what others tell you. Do not compare your level of feelings to other people's level of feelings. Do not measure your reunion against another's. This questionnaire is about you. We want to know how you feel.
Definitions: Definitions of terms used in this survey, as those terms apply to this research. These definitions are not necessarily the definitions generally used in the field of adoption, or by the general public.
Adult Adoptee: A person eighteen years of age and older who was adopted as an infant or toddler.
Birthfamily, birth-aunt, birth-sibling, etc.: A person who is related to the adoptee through genetics.
Birthfather: A male whose sperm was the genetic material for the adoptee, regardless of legal status to him or her. (Please do not be offended by the cold-scientific definition.)
Birthmother: A female whose egg was the genetic material for the adoptee, and who gave birth to him or her. (Please do not be offended by the cold-scientific definition.)
Emotional support group: A support group focusing on the emotional aspects of adoption search, reunion, and reconciliation. This type of group meeting does not involve search assistance.
Intermediary search: (a.k.a. active reunion registry) A search where the person doing the work is not the person desiring a reunion with an unknown party to the adoption. The intermediary is the one who makes the initial contact and requests permission for their identity to be disclosed to the searcher. If permission is refused, the actual searcher does not receive identifying information.
Reunion: The initial contacts between an adoptee and his or her birthfamily.
Reunion registry: there are two types of reunion registries, active and passive. An active registry is also known as an intermediary search. See intermediary search definition above. A passive registry is a depository where parties to an adoption can sign-up to have contact with their counterpart in adoption. Reunion registries are run by adoption agencies, state agencies, and volunteer adoption groups.
Search consultant: A person who will do most of the research for the searcher. Usually fee paid.
Search and support group: A support group focusing on the search aspects of adoption search and reunion. This group may have additional meetings for emotional support, but those meetings are not included in this definition.
Self-directed search: A search where the person desiring a reunion is doing most of the research is the searcher him or herself.
Stranger adoption: An adoption of an infant or toddler by adults who are not related to him or her by genetics or marriage. (The families may have known of each other at the time of the adoption, but subsequent to the adoption there was no contact until many years later.) Other types of adoptions, notincluded in this research, are stepparent adoptions, grandparent adoptions,or an aunt or uncle adopting a child related to them.
Section I:
1. I am a/n (Check all that apply.)
Birthmother
Birthfather
Adoptee
Adoptive parent
2. This is the birthparent questionnaire; it is for the reunion with my surrendered child.
True
Not true -- If not true, you need to go to the adoptee questionnaire.
3. I am the birthparent of child(ren) lost to adoption. (Fill-in the blank.)
4. I have had reunion(s) with child(ren) lost to adoption. (Fill-in the blank.)
5. I am submitting questionnaires representing my reunion(s). (Fill-in the blank.)
6. This is questionnaire of . (Fill-in the blanks.)
7. At the time of the reunion, my child was age: . (Fill-in the blank.)
8. The gender of my child is: Male Female
9. My child was born in: state, country.
10. Since the first contact with my surrendered child, we have been reunited for:
months and years. (Fill-in the blanks.)
11. Were you told your baby died at birth?
Yes
No
12. Were you aware you were a birthfather?
Not applicable
Yes
No
I had an idea, but was not sure
13. Did you search for your surrendered child, but found s/he had died before finding him or her? (If yes, skip Section II concerning a reunion with your child. Go to Section III for a reunion with other birthfamily members.)
Yes
No
Section II: Birthparent and Adoptee Reunion
14. Has your child died since finding him or her? (If yes, complete this section of the questionnaire for your feelings and relationship before his or her death.)
Yes
No
15. My reunion with my child involves:
 
16. My child . . .
 
| How much do you agree with the following statements? Check one: |
Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree | |
17. There are similarities between my child and me. (likes/dislikes, interests, personality, emotions, mannerisms, etc.) |
5 | 4 | 3 | 2 | 1 | |
18. My child looks like me, and/or my side of the family. |
5 | 4 | 3 | 2 | 1 | |
19. My child looks like the other side of his or her birthfamily. |
5 | 4 | 3 | 2 | 1 | |
20. I like my child’s lifestyle. |
5 | 4 | 3 | 2 | 1 | |
21. I like my child’s value systems. |
5 | 4 | 3 | 2 | 1 | |
22. My child and I have similar religious beliefs. |
5 | 4 | 3 | 2 | 1 | |
23. I like my child. |
5 | 4 | 3 | 2 | 1 | |
24. I love my child. |
5 | 4 | 3 | 2 | 1 | |
25. In some ways, I feel as if we were never separated. |
5 | 4 | 3 | 2 | 1 | |
26. My child and I have made up for lost time. |
5 | 4 | 3 | 2 | 1 | |
27. I feel connected to my child. |
5 | 4 | 3 | 2 | 1 | |
28. I feel I have a close relationship with my child. |
5 | 4 | 3 | 2 | 1 | |
29. I wish I had a closer relationship with my child. |
5 | 4 | 3 | 2 | 1 | |
30. I am satisfied with the relationship I have with my child. |
5 | 4 | 3 | 2 | 1 |
Section III: Birthparent and Grandchild(ren) Reunion
31. I have grandchild(ren) living through this adoptee. (Fill-in the blank--If none, go to Section IV.)
| How much do you agree with the following statements? Check one: |
Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree | |
32. I like my grandchild(ren). |
5 | 4 | 3 | 2 | 1 | |
33. I love my grandchild(ren). |
5 | 4 | 3 | 2 | 1 | |
34. I have a close relationship with at least one grandchild. |
5 | 4 | 3 | 2 | 1 | |
35. I am satisfied with the relationship I have with my grandchild(ren). |
5 | 4 | 3 | 2 | 1 |
Section IV: Overall Feelings about Reunion
| How much do you agree with the following statements? Check one: |
Not applicable | Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree |
36. I am glad I searched and found. |
N/A | 5 | 4 | 3 | 2 | 1 |
37. I am glad I was found. |
N/A | 5 | 4 | 3 | 2 | 1 |
38. I wish I would not have searched. |
N/A | 5 | 4 | 3 | 2 | 1 |
39. I wish I would not have been found. |
N/A | 5 | 4 | 3 | 2 | 1 |
 
| How much do you agree with the following statements? Check one: |
Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree | |
40. Before my reunion, I was not very hopeful about having a relationship with my surrendered child. |
5 | 4 | 3 | 2 | 1 | |
41. When I was reunited, I felt a peace I had not felt before. |
5 | 4 | 3 | 2 | 1 | |
42. My reunion is open, my family and friends know about it. |
5 | 4 | 3 | 2 | 1 | |
43. My reunion is open, my child's family and friends know about it. |
5 | 4 | 3 | 2 | 1 | |
44. My family and friends are supportive of my reunion. |
5 | 4 | 3 | 2 | 1 | |
45. Since my reunion, I feel more in control of my life. |
5 | 4 | 3 | 2 | 1 | |
46. Since my reunion, I feel I have more self-worth. |
5 | 4 | 3 | 2 | 1 | |
47. Since my reunion, I feel I have a more complete self-identity. |
5 | 4 | 3 | 2 | 1 | |
48. Since my reunion, I feel I have a better self-understanding. |
5 | 4 | 3 | 2 | 1 | |
49. Since my reunion, I feel I have more self determination. |
5 | 4 | 3 | 2 | 1 | |
50. Since my reunion, I feel more human. |
5 | 4 | 3 | 2 | 1 | |
51. Since my reunion, I feel more complete. |
5 | 4 | 3 | 2 | 1 | |
52. Since my reunion, I feel more like I belong. |
5 | 4 | 3 | 2 | 1 | |
53. Since my reunion, I feel I am more tolerant of other people. |
5 | 4 | 3 | 2 | 1 | |
54. I feel I have changed for the better since my reunion. |
5 | 4 | 3 | 2 | 1 | |
55. I feel I have changed for the worse since my reunion. |
5 | 4 | 3 | 2 | 1 | |
56. I do not feel I have changed significantly since my reunion. |
5 | 4 | 3 | 2 | 1 | |
57. I have come to terms with most of the things concerning this adoption. |
5 | 4 | 3 | 2 | 1 |
58. Overall, how satisfied are you with your reunion? (Check one.)
very satisfied.
satisfied.
dissatisfied.
very dissatisfied.
59. Overall, how successful is your reunion? (Check one.)
very successful.
successful.
unsuccessful.
very unsuccessful.
60. Assuming you expected to receive something good from search and/or reunion, what did you receive? (Select the one that most accurately describes your feelings.)
 
Section V: Search and Support Group Activities
61. Search and/or reunion process. (Select the one that most accurately describe your search activity.)
 
62. The person who made the initial contact in my reunion was:
 
63. The initial contact was by: (Check one.)
letter
phone
in person
64. I searched for: (Check one.)
N/A
0-5 mos.
6-11 mos.
1-3 years
more than 3 years
65. Before my reunion, I read adoption support books: (Check one.)
None
1-2
3-6
more than 7
66. After my reunion, I read adoption support books: (Check one.)
None
1-2
3-6
more than 7
| Check one response for each item:: | 0 times | 1-2 times | 3-6 times | 7-12 times | more than 12 times | |
67. Before my reunion, I actively participated in a search group. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
68. Before my reunion, I actively participated in an emotional group. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
69. After my reunion, I actively participated in a search group. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
70. After my reunion, I actively participated in an emotional group. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
71. Before my reunion, I actively participated in online bulletin boards and or chat rooms for search support. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
72. Before my reunion, I actively participated in online bulletin boards and or chat rooms for emotional support. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 | |
73. After my reunion, I actively participated in online bulletin boards and or chat rooms for emotional support. |
0 | 1 to 2 | 3 to 6 | 7 to 12 | more than 12 |
74. If you participated in adoption search or emotional support groups, please provide the name of the group and location:
Section VI: Other Adoption Activities
75. Since my reunion, I have . . . (Check all that apply.)
written at least one letter to a newspaper, magazine, or editor concerning adoption issues.
written at least one letter to a legislator concerning adoption issues.
testified at least once before a legislature concerning adoption issues.
participated in at least one public demonstration concerning adoption issues.
none of these
76. Since my reunion, I am (was) . . . (Check all that apply.)
a volunteer for a search and/or support group.
a search consultant.
involved in arranging adoptions.
none of these
77. Since my reunion, I returned to college to study . . . (Check all that apply.)
social sciences.
law.
other major. Please specify: .
not applicable
78. I am currently a . . . (Check all that apply.)
social worker.
licensed counselor.
psychologist/psychiatrist.
lawyer.
none of these
Section VII: About you
79. My current age is: (Fill-in the blank.)
80. At the time I was reunited I was:
 
81. At the time you were reunited did you have other children born to you who were not adopted?
Yes
No
82. At the time you were reunited had you adopted children?
Yes
No
83. At the time you were reunited did you have stepchildren?
Yes
No
You are not required to give your name and street address, but an email address is necessary for the form to process the responses properly.
Would you like a summary of the research project when completed?
Yes
No
Your name:
Your email address:
Your phone number (with country, city, area codes):
| Address: | |
| City/Town: | State/Prov.: Post./Zip Code: |
| Country: |
Section VIII - Optional Comments: Explanation of responses, questions that were not asked, anything you feel the questionnaire left out that you want to include. (Open question)
Please note: You must click the Submit Responses button for your questionnaire to be sent. It can take a moment or two for the form to process and take you to the next page. Please be patient. If you do not get an email in about thirty minutes with your responses to this questionnaire, it was not received. Please, try again.
Thank you,
Ginni D Snodgrass
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Ginni D Snodgrass
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