© 2007, AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses JOGNN 175 This article reviews research on the adapta- tion and transition to motherhood for women who adopt children, with the goal of identifying implica- tions for clinical practice. Relevant articles focusing on the early transitions to adoptive motherhood were identified by searching electronic databases. Evidence on the preadoptive and early postadop- tive periods was evaluated. The concepts identified by researchers and the women‘s feelings they described are discussed. Overall, the process of adaptation to motherhood was very similar, but adoptive parents reported unique emotions and concerns in the transition to parenthood. By under- standing these findings, nurses can help support adoptive mothers’ continued success in navigating stressful and uncertain paths to motherhood. JOGNN, 36, 175-182; 2007. DOI: 10.1111/ J.1552-6909.2007.00134.x Keywords : Adaptation—Adoption— Motherhood—Mothering—Transition Accepted: August 2006 There are many different ways for women to be- come mothers, including spontaneous conception, success with fertility technologies, surrogacy, and adoption. No matter how a woman becomes a mother, by adoption or otherwise, she faces a unique set of challenges in her role transition. According to Mercer (2004), “The transition to motherhood is a major developmental life event. Becoming a mother involves moving from a known, current reality to an unknown, new reality” (p. 226). By gaining a greater understanding of the adaptation process for adoptive mothers, nurses can start to transform clinical practice to provide more comprehensive care for spe- cial mothering populations. To strengthen clinical practice, nurses can learn from general statistical trends, traditional theories on motherhood, and the current literature on the transition and adaptation to adoptive motherhood. Prevalence of Adoption The process of adoption varies and includes a number of different routes. Examples of these are domestic (foster, kinship, infant, customary, and private) and intercountry (Child Welfare Informa- tion Gateway [CWIG] n.d.). Many more women may consider adoption than take steps to pursue it. In the latest available report (Chandra, Abma, Maza, & Bachrach, 1999), in 1995, among ever-married women aged 18 to 44, 9.9 million women had con- sidered adoption, and, of these women, 1.6 had taken steps toward adoption. Preferences varied as to age of child, race, disability status, and number of children desired. The prevalence of adoption was higher in women of advancing age, education, and income. The CWIG (2004) reported that since 1987, numbers of adoptions have remained relatively constant. In 2000 and 2001, approximately 127,000 children were adopted in the United States Of those, 39% were public, 15% were intercoun- try, and 46% were private adoptions. These num- bers are very different from the CWIG’s 1992 statistics, when 18% of adoptions were public, 5% intercountry, and 77% private (CWIG), demon- strating a large increase in public and intercountry adoption. CLINICAL ISSUES Transition and Adaptation to Adoptive Motherhood Holly B. Fontenot