This letter was written by the late, Eugene T. Kelley. Although some things within the hospital setting have changed since the pandemic began, this is a great depiction of what an adopting couple can expect during their hospital stay as written by a true expert in the field of adoption.

What you Should Expect When the Birthmother Goes into Labor

Mar 7, 2022

During my thirty plus years in the adoption practice here in Arkansas I have been in more Arkansas hospitals than many, if not most medical doctors. Typically, each hospital has some sort of adoption procedure or protocol for handling adoptions. Arkansas statutes allow hospitals to create and have their own legal documents for the birth mother, the adopting family, and the discharge of the baby. Additionally, most hospitals require a court order directing or permitting the adopting family to have bonding time with the baby in the hospital and a directive to discharge the baby directly to the adopting family. Usually there is a case worker that coordinates and monitors the interaction between hospital personnel, the birth mother, and the adopting family. It is advisable that a letter is prepared by the agency wherein the birth mother and adopting family agree as to how things or events will transpire while the birth mother is in the hospital. Usually, the birth mother will be discharged 24 to 48 hours after birth. While in the hospital, even though the birth mother may have signed a document surrendering her rights to the baby, Arkansas law allows the birth mother to revoke surrender of rights during the five-day period after the birth; therefore, the hospital staff looks first to the birth mother as far as the ultimate decision maker during her stay.


While talking about stays in the hospital, most hospitals provide a private room for the adopting family to stay in, free of charge and subject to availability. The adoption case worker will usually request the adopting family’s insurance information that is necessary for medical services not covered by the Birth Mother’s insurance or Medicaid. This is normal procedure, and the adopting family should cooperate. Most birth mothers will qualify for Arkansas Medicaid (but in some cases it may need to be applied for at the hospital). It is always wise to have the Medicaid in place as soon as possible – both for health services and financial planning. Medicaid can be applied for up to 90 days from the birth of the baby.

A word to the wise, hospitals and doctors tend to have their own time measurements such as discharge after 24 hours from birth, but do not plan on it. It may occur about on time but depending on a wave of new births it could be 3, 4, or more hours late. With everything going on in the hospital you need to anticipate delays and postponements. It is a good rule of thumb to take the first opportunity to be discharged, i.e., have the circumcision done by your personal pediatrician. As long as you remain in the hospital you are not in control of the situation or your baby. That is not to say to disregard medical advice, but only to put yourself in control of the situation.


During the hospital stay, the birth mother will be asked to fill out hospital forms. One such form is the birth certificate information such as first, middle, and last name. The name of the father may be left blank if the father is unknown or there may be uncertainty as to the biological father. If the birth mother is married the husband’s name should be listed. The birth mother may name the baby any first or middle name, but the last name should be the birth mother’s. The adoption attorney will need to know for certain what name was placed on the original birth certificate so that when the adoption is finalized the state agency will be able to cross reference the birth certificates. The birth mother should NOT apply for a social security number at the hospital The adopting family will do so after the adoption is final, and they have the new birth certificate. The social security number will be applied for at the Social Security office in the adopting family’s hometown.


It is advisable for the car seat to be new and have a proper safety rating. The seat should be installed multiple times prior to discharge at the hospital. There have been occasions when the hospital has not allowed the car seat to be used because of the safety concerns. Also, it is frustrating to try to install the seat at the hospital at discharge when the installer is not able to secure the seat properly.

The adopting family may be given an appointment for an examination of the baby by a local pediatrician. Following through with this recommendation is appropriate, but as a general rule I prefer that the adopting family come to Northwest Arkansas where I am located as soon as able. I have had adopting parents run into birth fathers at Walmart and convenience stores. It created an awkward situation to say the least.

I am taking this opportunity to list some of the hospitals that I have traveled to help with the discharge of the baby. I also list the current case worker that manages adoption matters at each hospital. I tell a little story about my being present at discharge of a baby at St. Edward’s Hospital (now Mercy Hospital) in Fort Smith, Arkansas. At the discharge, the case worker asked for my driver’s license so that a copy could be made and placed with the discharge papers. It just so happened that I had a second discharge appointment at the Mena, Arkansas hospital some thirty-five miles south of St. Edwards. Again, the case worker asked for my driver’s license in connection with the second baby. I anxiously looked in my bill fold for my driver’s license and could not find it. It then dawned on me that it was left at St. Edward’s Hospital. I was advised that the baby could not be discharged without photo identification. I did not want to drive 35 miles north and 35 miles back, so I looked again in my bill fold and saw my picture on a Sam’s Club membership card so I presented it to the case worker and she said that it would work…so in Arkansas, if need be, I can get a baby out of a hospital with a Sam’s card.

A final word about hospitals and medical personal – they are very clean, up to date with very pleasant and qualified staff. It is not unusual for adopting families from out of state to remark on how well they were treated by the nurses and staff.