Pat's baby was, like the child of Hester Prynne, a pearl of great price. Pat chose to bring life out of an unwanted pregnancy, and for it suffered serious illness, destitution and fear.
Unable to call on her parents or the baby's father for help, with neither education nor a job to provide support, Pat was on her own to find shelter and medical care when she became pregnant last year. "My boyfriend was for abortion, he wouldn't marry me," she says. "But I don't believe in abortion."
Relations with her parents were so bad, Pat says, she did not even tell them she was pregnant before leaving home after a "terrible" argument with her mother. Pat wanted to give birth, she says, but knew she couldn't take care of two people by herself. "I knew right away I wanted to place the baby for adoption," she says.
Pat's efforts to find a safe haven during her pregnancy led her to the Christian Family Care Agency in Phoenix, a nonprofit agency, and later to the for-profit Southwest Adoption Center, Inc., in Scottsdale, the largest adoption agency in the state.
What she didn't know, in deciding on adoption, was that she was stepping into the middle of a "trade war" between Phoenix's adoption agencies. By the time her baby was born, she had dealt with two of the main adversaries in the fierce competition for the limited number of babies put up for adoption each year.
Southwest is under particular attack by the nonprofit agencies for shipping large numbers of Arizona babies to wealthy out-of-state couples while Arizona couples stand in line to adopt. Southwest handles the largest volume of adoptions of any private agency in the state and two thirds of its adoptions are to out-of-state couples.
The smaller nonprofit agencies, many of them with religious affiliations, say they can't compete with the for-profit agency's big advertising budget and nationwide connections.
"Wealthy couples from back East can afford to pay much higher fees than many Arizona couples," says Shirley Pusey, a child-welfare worker with the nonprofit Family Services Agency in Phoenix, the state's oldest adoption agency. "The higher fees go to support big advertising and public-relations campaigns that enable the for-profit agencies to attract more birth mothers. It's very difficult for the nonprofits, which charge minimal fees, to compete."
The nonprofit agencies would like to see for-profit adoption outlawed in Arizona, as it has been in Michigan, says Kay Ekstrom, executive director of Christian Family Care Agency, which handles the most adoptions of any nonprofit agency in the state. And she's got the ear of at least one influential legislator, Mesa Republican Leslie Whiting Johnson, chairman of the Arizona state House Committee on Human Resources and Aging.
"Southwest Adoption Center is definitely the main source of concern," Johnson says.
"I'm concerned that when these babies are transported out of state, Arizona loses control over the situation surrounding the adoption," Johnson says. "Our own laws are very strong, but in some states there are not a lot of guarantees to ensure the baby goes into a safe environment."
Mike Sullivan, president of Southwest Adoption Center, contends this war is not about ideals, but jealousy. "Every year there's a bill in the legislature to put Southwest out of business," he says. "The other agencies don't want to face the fact we're the most successful because we offer the best service to birth mothers and adoptive parents both."
Lance all the rhetoric, Sullivan claims, and his opponents' arguments can't be supported by fact. "It's ludicrous to say so many babies are going out of state that Arizona couples are being penalized," he says. "And how can you talk about a law to restrict out-of-state placements when there is an Interstate Compact specifically to allow interstate adoptions?"
Earlier this year, however, Johnson introduced legislation to do just that--limit out-of-state adoptions. The bill died because of "technical difficulties," she says, but the issue is very much alive.
"I'm going to be getting back together with Kay and the folks from [the state Department of Economic Security] to draft another bill for the upcoming session," Johnson says.
If Pat's story illuminates anything, however, it is that this war will be won not by new laws, but by whoever is willing to treat birth mothers as people, rather than commodities.
THOUGH MORE THAN two centuries separate Pat, who has spent most of her 24 years in Phoenix, from author Nathaniel Hawthorne's Puritan heroine, her experiences as an unwed mother are equally poignant.
An experienced survivor of the city's rough underside, Pat says matter-of-factly, "I'm not the kind of person to express my feelings." She is whip-thin and tiny, with hair the color of desert sand. Over the years, she has developed an exterior that allows a lot of hard knocks to slide off with no apparent effect. Yet as she delves into the events surrounding the birth of her daughter in 1987, her armor barely hides the vulnerability beneath it.
Although Pat is still in her early twenties, perpetual strain is beginning to etch her face. Accustomed to taking life as a series of crises, she sees neither the past nor the future with much focus. Things happen, and she reacts, as when she became pregnant through a lapse of caution.
"I got pregnant by accident," Pat says. "I was partyin', havin' fun--what else can I say?" She had been living at home in an uneasy truce with her parents, but after a particularly bad row with her mother, Pat stormed out of the house for good.
Pregnant, now homeless, she turned to her boyfriend. Pat says he urged her to seek an abortion, to rid herself of a pregnancy that was neither planned nor wanted. He still wanted to be part of her life, but he wasn't ready for a family, she says.
Instead, Pat called the Christian Family Care Agency, which she had found through an ad in the phone book. "They came and picked me up and told me they'd house me, take care of me and put the baby up for adoption," she recalls. "It sounded fine so I said okay."
"They took me to a place in South Phoenix, like a small apartment complex, where most of the girls stayed, next to a main house, where about six or seven real young girls stayed," Pat says. "Once we got there, they told me about the rules: One, get a job; two, use the money from it to pay room and board; and three, I had to go to Bible study and church services with the group."
"The younger girls' room and board was paid by their parents," she says. "I was assigned to an apartment with a roommate and she said it was an okay place, so I started to calm down a little."
The following day, Pat says, incidents began occurring which convinced her she'd made a serious mistake in accepting the agency's offer of help. Far from providing a safe and tranquil place to wait out her time, Pat claims, officials at the home seemed obsessed with controlling the pregnant women in their care and making them admit they had sinned.
"The day after I got there, I walked across the street to a Smitty's supermarket to buy a snack and when I got back, the two adults in charge just blew up," she says. "They said I couldn't leave the grounds without permission. I couldn't have my boyfriend or anyone else visit without their permission.
"The other girls accepted the control, but I was 22 years old," she adds. "I thought I would be able to come and go as I wanted."
Pat says she resisted going to Bible study, but her boyfriend urged her to cooperate. "`Pat,' he said, `it's not going to kill you to go to Bible study once a week.' So I went," she says. "They preached to you, condemned you for getting pregnant. Everyone else there seemed to agree with that, that they'd done wrong, sinned, and were giving up their babies because they knew they couldn't be a good mother."
Nothing, it seems, exempted a girl from the Bible study tirade, Pat recalls. "One of the girls was retarded and they even went on at her about how she'd sinned." As Pat saw it, she owed no one an apology. She had "chosen life" over abortion and was following through on her responsibility to her unborn child. "I just wanted to be left alone. I just didn't want anybody hassling me until my baby was born," she explains.
Ekstrom says the facility at which Pat stayed has been closed, and that it is not the agency's policy to force religion on its clients. She admits, however, that some volunteers with the agency at times might do so. "It's unfortunate that young woman had that kind of an experience with our agency because it is contrary to our policy," Ekstrom says. "When [pregnant] women come here, the last thing we need to tell them is that they need to atone. The message we're trying to get across is God's forgiveness and acceptance."
Within days of her arrival, Pat claims, she fled the Christian Family Care home in a panic, after being threatened with transfer to an isolated rural facility because she was "causing problems and not fitting in."
"They said they were going to move me to a house out of town," she says. "I promised to cooperate and they let me go back to the main house for group activities that night. I saw an ad on TV for Southwest and memorized the phone number."
"They locked us in our rooms at night, but after lights out I snuck out a window and went over to the Smitty's and called Mike [Sullivan]," Pat says. "He said he would send someone over for me. When I saw the car lights, I crawled out the window and jumped in the car and we took off."
"I didn't even think about going to the cops," she says. "I was afraid Christian Family Care would come after me. I still am afraid of them."
Sullivan recalls reacting with disbelief when Pat called and told him she was "being held against her will" at the Christian Family Care home. "She said they wouldn't let her leave and I sort of laughed and said, `No, this is the United States of America, you just get up and walk out the front door if you want to leave,'" he says. "I couldn't believe [that] Pat had to crawl out the window of her apartment."
Ekstrom acknowledges receiving complaints similar to Pat's from others who stayed at the facility, and says the agency closed it permanently shortly afterward because "it was difficult to provide adequate oversight" and the property owner asked to regain control of it. Young women who need a place to live are now housed with individual families who volunteer with the agency, she notes.
The person who picked Pat up when she called Southwest, social services director Mary Kate Harris, became her closest friend throughout the rest of her pregnancy, Pat says. "Mary Kate was great. She got me signed up [on the state's indigent health-care program] and set me up to stay with a family waiting to adopt.
"She was my counselor for the rest of the time I was at Southwest," she says.
Pat was to provide childcare for the family with which she was living but, shortly after settling in, she learned she was carrying twins and began to develop medical complications. Midway through the pregnancy, one twin died in utero.
After that, Sullivan says, he invited her to spend the rest of her pregnancy in a spare room at his house. "After what she had gone through, I didn't feel it was fair to ask her to help support herself," he says. "She really had some [medical] problems to deal with."
Pat's remaining twin was born with cystic fibrosis, a serious chronic illness. But the couple waiting to adopt the baby said it did not matter and, 72 hours after the birth, Pat gave legal approval for the adoption of her baby.
"I wanted someone who could afford to care for her," Pat says. "I had the option to see her and to meet them, but I didn't want to because I knew I might change my mind." So she steeled herself against her misgivings in the same way she once steeled herself against the other threats she had faced.
"She's fine now, the baby's doing fine now," Pat says, as if to push away the implications of the baby's diagnosis.
Pat says she is grateful to Southwest for the support and shelter she received from the agency. Southwest, however, arouses just the opposite feeling in the smaller, nonprofit adoption agencies who question the practices of for-profit agencies and their ultimate impact on the welfare of babies put up for adoption in Arizona.
CRITICS OF SOUTHWEST Adoption Center charge that it functions more as a baby broker than as a legitimate adoption agency. They contend that because Southwest is profit-motivated, it looks first at a couple's ability to pay, and second at the ability to parent.
And, Pat's experience notwithstanding, the for-profit agencies usually dump imperfect babies, officials at other agencies say. "They skim the healthy white infants, what we call the Gerber babies, that can be easily placed, and send the hard-to-place babies to us," says Ekstrom, whose agency placed 56 infants last year, almost one third of them in the "special-needs" category. Such children include those with serious health problems or birth defects or children of mixed race.
"People are out there willing to adopt special-needs children, but you have to beat the bushes to find them," she says. "The practice of only accepting perfect babies is indicative that profit is what counts at some agencies."
Ekstrom says she does not support legislation restricting out-of-state placements and actually asked Johnson to withdraw last year's bill because she does not believe it will solve the problems posed by allowing a for-profit adoption industry to flourish. "I'd like to see a bill ideally where all adoption is done through licensed nonprofit agencies," she says.
"It's not gonna happen because the attorney lobby is so strong it won't fly," says Ekstrom. "Some attorneys accept small fees but there are attorneys who make a lot of money off doing private adoptions, you know. And the concern is, beyond money, that the attorneys aren't providing the support services needed to make sure the adoption is good for everyone."
For-profit agencies charge fees that few people on Arizona's wage scale can afford. Because of the cost, most of these babies wind up in the homes of wealthy out-of-state couples, many in East Coast states, critics contend.
No agency keeps figures for the total number of babies adopted within Arizona each year, or the number of couples waiting to adopt, but county and state officials agree the vast majority are in Maricopa County. Between 600 and 700 couples apply to be certified as adoptive parents in Maricopa County each year, says Mary Verdier, a Superior Court commissioner who handles all certifications and most of the adoption hearings that take place in metropolitan Phoenix. Of the 845 adoptions approved in the county last year, Verdier estimates that as many as half involved older children being adopted by stepparents or relatives.
Last year 225 children between the ages of birth and eighteen were taken out of Arizona for adoption, according to the local office of the Interstate Compact on the Placement of Children. Although some older children were among them, most were babies, says Mike Chapman, Interstate Compact coordinator for Arizona.
National Interstate Compact executive director Kathleen Tucker says her agency cannot confirm or refute concerns that Arizona is functioning as a baby factory for the rest of the country. Agency figures do confirm that Arizona, one of the least populous states in the union, accounted for close to 10 percent of all interstate adoptions nationwide last year.
However, Arizona also has the second highest rate of teen pregnancy in the country. Neither the Interstate Compact nor adoption agency officials in Arizona have analyzed the impact, if any, of this phenomenon on the number of babies available for adoption from various states.
Last year, Southwest Adoption Center handled about 75 of Arizona's out-of-state adoptions, or about one third of the total, according to figures supplied by Sullivan. He admits that most of his agency's placements are to out-of-state couples. "We average about 25 to 30 in-state placements each year," Sullivan says.
But he defends the high rate of out-of-state placements and the agency's fee of $13,500--about twice the amount charged by most nonprofit agencies in Arizona. "The larger the pool of parents you have to choose from, the better the opportunity to find the family that is right for an individual baby," Sullivan argues. "We do give priority to Arizona couples, but they're no more burdened than any other couple by the wait--there are waiting lists all over the country for people wanting to adopt newborns."
Agencies contacted by New Times say there are 150 to 200 families on their waiting lists. The waiting time, however, varies substantially. Most of the nonprofits contacted report that families wanting to adopt a healthy, white newborn must wait at least two years. The wait at Southwest is about half that time.
"Many of our birth mothers don't like the idea of a child being placed in Arizona," Sullivan adds, "because they don't want to wonder every time they see a baby, `Is that one mine?'"
Representative Johnson, for one, wonders if the babies really are going to better homes. "Whether or not they are brokering to the highest bidder, the point is we don't know what standards are being observed in selecting the families for placement," says Johnson, who adopted all of her own children. "Since standards vary greatly from state to state, what are they following?"
Sullivan says his agency follows each state's guidelines. He acknowledges that Southwest accepts applications from couples "other agencies wouldn't touch" because of age, inter-religious marriage or agency-imposed restrictions on the number of adopted children already in the family. But he contends that prospective parents are screened rigorously.
"We're seeing some agencies, particularly those with a strong fundamentalist bent, set up religious requirements that seem to us to be arbitrary," he says.
Mike Chapman, who oversees the transfer of Arizona children bound for out-of-state placement by Southwest and other agencies, acknowledges that adoption procedures vary from state to state. But, he adds, "Each adoption still must go in front of a judge and be approved. The purpose of the Interstate Compact is to track children and to make sure they aren't going into slavery or being abused.
"I think it would be real tough to say one state was better than another in terms of standards," Chapman says. "There are a lot of people interested in making sure it's done right and to make sure the children are going to safe places."
Sullivan acknowledges that part of the reason his agency's fee exceeds that of most other agencies is the amount spent on advertising. "Pregnant? Thinking about adoption?" ads adorn bus stops throughout the city, and late-night television ads cleverly target pregnant women who may be brooding sleeplessly about their futures.
"How else could you reach the birth mothers but with ads?" Sullivan says. "Last year we serviced 350 birth mothers, of which only 98 ended up placing. The only way we have of covering most of those costs is the fees we charge."
The real reason Southwest Adoption Center is beating the competition, Sullivan asserts, is the service it offers, beginning with an atmosphere free of moral judgment. Pat's account of feeling recrimination and blame from another agency is not unique, he says.
Pregnant, unwed women no longer spend their days embroidering scarlet A's on their clothes, but many say discrimination and moral condemnation are real. Real enough, they say, to make Pat and half a dozen other unwed mothers New Times interviewed for this story insist on anonymity as a condition for talking.
"A lot of birth mothers come here from other programs," Sullivan says. "They often feel the organization tried to force something on them. They felt they were being judged morally . . . . Frequently religious dogma was involved."
He asserts that Southwest's big fees pay for services most other agencies cannot offer, including housing during the last two months of pregnancy and health care through a private doctor if the mother so chooses. Southwest offers unlimited counseling before and after the birth, through individual counseling and a birth-mother support group, Sullivan says.
"We never try to talk a mother into doing anything," he says. "Someone who has to be talked into adoption is a very poor candidate for it, anyway."
Indeed, the only complaint against Southwest on file with DES, which licenses the agency, concerns a birth father upset because the birth mother decided not to place a baby and he was afraid he would have to pay child support.
Critics, however, include a birth mother who says she glimpsed a different side to Sullivan when she wavered in her decision to give up her baby for adoption two years ago.
"They treated me very well up until the time the baby was born," says Dee, a 42-year-old Phoenix woman. Following the birth, she says, no one associated with Southwest displayed any concern for her feelings even after her estranged husband called and threatened to make trouble if she followed through on her adoption plan. "They were so businesslike, it was like my feelings didn't matter."
"The Southwest social-services director showed up at my bedside the day the baby was born to have me sign papers giving them temporary custody and insisted I be ready to sign the adoption papers exactly 72 hours later," Dee recalls. "A friend who was there visiting said, `Can't you wait another day, for heaven's sake, that's her birthday,' but they were adamant."
"I did receive counseling twice before the baby was born but, in retrospect, they really didn't encourage you to examine your decision too deeply," she says. "It was as if they didn't want you to look too closely because you might change your mind."
"After my husband threatened to come and take the baby from the hospital himself, I called Mike [Sullivan] and Mike said, `That's all right, we'll just hit him with a bill for $6,000 in services,'" she says. "It sent a chill down my spine because I felt like he could do that to me if I changed my mind about the adoption."
Both for-profit and nonprofit agencies require pregnant women who accept their help to sign agreements promising to repay at least some expenses if the mothers decide not to place their babies for adoption. Officials at nonprofit agencies contend, however, that they work harder to keep costs down from the outset and require only that a woman pay her own medical costs.
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"In a for-profit agency, the whole system of services is aimed at validating a woman's decision to adopt," Ekstrom says. "We spend hours counseling a woman on the right choice for her, on how to make a good decision. This is because many of the nonprofit agencies aren't just adoption agencies; they offer broad-based social services."
IN A TIME WHEN the only bar to early abortion is individual conscience, Pat, at least, chose her path voluntarily.
But the coming years promise that more women will find themselves in her position, perhaps involuntarily, as the U.S. Supreme Court's new conservative majority makes its effects felt on abortion availability. In states such as Arizona, where laws are already in place limiting access to abortion by the most powerless groups--poor women and pregnant teens--further restrictions seem likely to increase the number of pregnant women with no real way to keep the babies they bear.
Conservative legislators say they stand ready to push legislation to protect these newborns from the vagaries of the marketplace. They might do well to start by figuring out how best to protect the babies' mothers from exploitation in the same marketplace.