Alexander Demianchuk / Reuters

Along the highways of states where support for abortion is at its lowest, it’s not uncommon to see road signs that say choose adoption and similar messages. The signs capture a preferred anti-abortion retort to outcries over abortion restrictions, like the kind Georgia and Alabama just passed: Women with unwanted pregnancies should find adoptive families.

Adoption is a choice that certain women who don’t wish to keep their babies enter into happily. Some women find abortion to be anathema and rule it out among their options for an unwanted pregnancy. And for women considering abortion who ultimately settle on adoption, the process often benefits everyone involved.

Of course, adoption is not a reasonable option for all pregnant women. Some girls and women would imperil their health if they carried a baby to term. Many pro-abortion-rights people believe it is immoral to compel a woman to carry a pregnancy she does not want, especially if that pregnancy is a result of rape or incest. And some studies show that abortion is medically safer than childbirth.

But even among American women for whom carrying a child to term would be safe, adoption is a remarkably unpopular course of action. Though exact estimates for all women are hard to come by, the Centers for Disease Control and Prevention reports that among never-married women, about 9 percent chose adoption before 1973, when Roe v. Wade legalized abortion. (The figure was higher for white women: 19 percent.) By the mid-1980s, the figure had dropped to 2 percent, and it was just 1 percent by 2002, the last year the CDC data captured. In 2014, only 18,000 children under the age of 2 were placed with adoption agencies. By comparison, there are about 1 million abortions each year.

The available research on adoption’s relative unpopularity is still limited. But the sociological studies that exist suggest that some women who are deciding between adoption and abortion find adoption to be more emotionally painful than abortion. And the reason complicates the narrative around abortion on both sides.

For the most part, women are not choosing abortion instead of adoption. In fact, both adoption and abortion rates have fallen over time, while births to unmarried women have risen over the past few decades. This suggests to some researchers that women are choosing between abortion and parenting, and more and more, unmarried women are choosing parenting. “Women just generally aren’t interested in adoption as a reproductive choice,” says Gretchen Sisson, a sociologist at the Advancing New Standards in Reproductive Health research group of the University of California at San Francisco. “It’s an extremely rare pregnancy decision.”

The move away from adoption is part of the historical trend toward reduced societal stigma for unwed mothers. Today, women who are inclined to go through with a pregnancy are simply keeping their babies. In a 1992 story about the drop in adoption placements, Debra Kalmuss, a professor at the Columbia University School of Public Health, told The New York Times that in past decades, many unmarried women had been sequestered during their pregnancies. The babies were placed with adoption agencies, and the women returned to their normal life. “Relinquishing a baby for adoption really ceased to be a mainstream choice after abortion became legal,” Kalmuss told the paper.

Meanwhile, many pregnant women who don’t wish to become mothers seem to have a dim view of the adoption process, according to a study that Sisson and her colleagues published in 2017 in the journal Women’s Health Issues. The researchers relied on the Turnaway Study, a five-year, longitudinal look at women who sought abortions at 30 U.S. clinics from 2008 to 2010. The authors interviewed 956 women, 161 of whom went on to give birth, and 15 of whom chose adoption. They also had more in-depth conversations with 31 of those women, 16 of whom received abortions, and the rest who did not.

The authors note that the women seem to consider their options sequentially: They first seek abortion, and if they can’t afford or access one, they might then consider adoption. A week after being denied an abortion, 14 percent of the women said they were considering putting the baby up for adoption instead. But ultimately, only 9 percent of the women who were denied an abortion chose adoption. The majority simply went on to parent.

Meanwhile, none of the 16 women who got abortions were at all interested in adoption at any point. Some of their reasons were practical: “Adoption was often ruled out because they felt it was not right for them, because their partner would not be interested, because they had health reasons for not wanting to carry to term, or because they believed there were already enough children in need of homes,” the authors write.

The mothers who did choose adoption ultimately reported that they were happy with their decision. But Sisson told me that, at least initially, “adoption can be deeply traumatic. Uniformly, the birth mothers experience grief after placement. It’s a very hard choice and one that a lot of women are not interested in making.”

In the study, several women expressed an unwillingness to part with a baby they had carried to term and given birth to. “I had too many feelings for her to give [her] to someone I barely knew,” one woman said. Some said they would feel guilty placing their children with adoption agencies, and one even imagined the fully grown child coming back one day and interrogating her about her choice. “By the time they are delivering the child, women feel bonded to their pregnancies and their children,” Sisson said.

Sisson also performed a small study on mothers who placed their children with adoption agencies from 1962 to 2009. These women, she writes, were also largely choosing between abortion and parenting. “Rarely was adoption the preferred course of action; it emerged as a solution when women felt they had no other options,” Sisson wrote. Even among these women, who were not recruited from abortion clinics, a majority of the participants described their adoption experiences as “predominantly negative.” Most of the negative experiences involved “closed” adoptions, in which the birth parents have no contact with the child. Today, “open” adoptions are more common, and many experts and families believe that they create healthier situations for parents and children. But arguably every kind of adoption comes with its own complications.

Sisson’s findings echo a study published in 2008 of 38 women who were getting abortions. It found that a quarter of the women had considered adoption, but they largely regarded it as too emotionally distressing. “Respondents said that the thought of one’s child being out in the world without knowing whether it was being taken care of or who was taking care of it was more guilt inducing than having an abortion,” wrote the authors, who are researchers from the abortion-rights think tank the Guttmacher Institute. In another Guttmacher study of women seeking abortions, in 2005, one-third of women considered adoption but “concluded that it was a morally unconscionable option because giving one’s child away is wrong.”

Like in Sisson’s paper, one respondent in the 2008 study referenced the bond she expected to form with the baby as the factor that prevented her from going with adoption. “If I go that far, I’m attached. I cannot just give my baby away to someone,” said an unmarried, 24-year-old mother of two.

I reached out to National Right to Life for comment about these studies, and will update this story if I hear back from them. Chuck Johnson, the president of the National Council for Adoption, an adoption-advocacy group, says part of the reason for adoption’s unpopularity might be that both anti-abortion and pro-abortion-rights groups fail to counsel pregnant women adequately about adoption. According to the group’s statistics, the referral rate to adoption agencies for both kinds of centers is about 1 percent.

What’s more, many people view adoption as “a difficult decision for the mother,” Johnson told me via email. “Although the general public views adoption as a good outcome for the child and the adopting family, the idea that adoption promotes the woman’s best interests is not as fully embraced by those that are on [the] front lines [of] options counseling—or by the mother herself or her family.”

In the end, this line of research is not especially vindicating for either the defenders or opponents of abortion rights. Rightly or wrongly, very few women who desire abortions actually see adoption as a favorable alternative. In fact, some of these papers end with policy recommendations along these lines: “The ongoing promotion of adoption by the American anti-abortion movement is unlikely to impact women’s abortion decisions, because very few women pursuing abortion are interested in adoption,” Sisson and her colleagues write.

But the reason the women don’t choose adoption is not great for the pro-choice side, either. Some of these women report feeling bonded with their fetuses, or at least too attached to give up the resulting baby. That’s an inconvenient point if you feel that a fetus is nothing more than a collection of cells, and that what happens to it before viability is basically immaterial.

Together, the results suggest that if the rate of unintended pregnancies remains constant, but abortion restrictions are tightened, the U.S. won’t necessarily see a spike in domestic adoptions. Instead, there are likely be more mothers who initially didn’t want to give birth to their babies, but decide to raise them nonetheless.

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