With the overthrow of Romania's communist regime in December 1989, numerous American and Western European couples went to Romania seeking children to adopt. It was reported that orphanages were full of neglected children abandoned by parents who could not support them. In 1991, a total of 2,552 Romanian children were adopted by American families. However, due to international outrage and criticism over the black-marketing of babies during this period and the adjustment difficulties experienced by adoptees who displayed emotional problems and developmental delays, Romania reduced its number of foreign adoptions. In 1997, the Romanian government reformed the adoption process with the goal of decreasing the long-term institutionalization of its children and better regulating the adoption of children abroad.

Adopting from Russia and other countries of the former Soviet Union has become popular since the collapse of the Union, and today, Americans are adopting more children from Russia than any other country in the world. Last year, 4,348 Russian children were brought into American homes (compared to 12 adopted in 1991).

In the early years of international adoptions, American adoptive parents were not necessarily childless couples. These early adoptive parents often had biological children and were religious and family-oriented. Their primary motives for adopting internationally were humanitarian. Today, the majority of adoptive parents are infertile couples who are motivated by the desire to have a family and offer a home to a needy child. While the majority of adoptive couples are white, there are increasing numbers of Asian American couples and single parents who are adopting from countries like China.

From its inception, the practice of international adoptions has raised many questions and remains controversial today. Are international adoptions in the best interest of the child? Under what kind of duress and economic/social pressures are birth parents when they relinquish a child, and is such a decision really made of free will? Will the child have difficulties adjusting to a new culture, society and language? Will the child experience racial discrimination and cultural/familial identity conflicts when entering adolescence and early adulthood? Should couples from wealthy Western countries "buy" babies from under-developed countries, and what is the global power-dynamics inherent in such a relationship? Could the money spent on international adoptions be spent in developing greater support for children and families in various countries in order to prevent the need for international adoption?

While there are no easy answers, these questions are important to consider as the practice of international adoptions continues to flourish.