Russia's ban on U.S. adoptions is the latest setback for hopeful American parents as countries increasingly impose restrictions.
Other countries, including China and Guatemala, have erected hurdles for adoptive families as they create their own domestic adoption programs.
The signing of the Hague Convention on Adoption in 2008 drastically improved regulation of the process, which had been rife with corruption. But it has also led to a slowdown in adoptions or shutdowns in some countries. Internal politics and abuse concerns are additional reasons countries have tightened controls.
In 2004, U.S. citizens adopted 22,991 children born abroad, an all-time high, according to Adoptive Families magazine. By 2011, that number had fallen to 9,319.
There are still other options for Americans wanting to adopt an international child. Bulgaria, Colombia and many African nations are some of the new go-to countries for U.S. adoptions.
But even that's not a sure thing. For would-be adoptive parents, the best bet is to widen their search to include special-needs children, sibling groups and older children.
Africa, which represented 22 percent of adoptions in 2009, is expected to be a bigger player in the future.
"A decade ago, there were very few adoptions [in Africa]," said Susan Soonkeum Cox, vice president for policy and external affairs at Holt International, a Christian adoption organization in the U.S. "Now, there's an explosion."
African countries seeing an increase in adoptions include South Africa, the Democratic Republic of the Congo, Ghana, Kenya and Ivory Coast.
Adoptions in Ethiopia, meanwhile, have declined from a peak of 2,511 in 2010 as the country overhauled its oversight process. But it is still a viable option, Cox said.
Cox advises working with an adoption agency that has staff on the ground in Africa and other countries to handle paperwork and advocate for U.S. families.
Other countries that still welcome American adoptions include Bulgaria and Colombia, said Megan Montgomery, international adoption coordinator for Adoption Star, based in Amherst, New York.
Adoption Star deals primarily with adoptions in Bulgaria, a country that has gone from five placements in 2008 to 75 adoptions in 2011. Placements from Vietnam and Cambodia, which shuttered their U.S. adoption programs, should resume soon, adoption experts say.
Adoptions of Russian children peaked in 2004, said Dale Eldridge, coordinator of adoptive services at Jewish Family Services' Adoption Choices, a nonprofit adoption program based in Framingham, Massachusetts.
Right now, fewer than 50 U.S. adoptions of Russian children are formally in the works, while another 250 U.S. families have identified children they would like to adopt, adoption experts said.
Unfortunately, families that have already started an adoption in Russia can't just flip a switch and redirect their efforts to another country.
"I wish it was as simple as taking some families who have been waiting [for Russian children] to just move over to another country," said David Nish, chief program officer at Spence-Chapin, a U.S.-based adoption agency that finds homes for children in the United States and around the world. "But it's a whole other process."
That's because every country has its own eligibility requirements. Criteria can include parents' marital status, age of the parents, employment, financial status, medical issues, and even the age difference between the adoptive parents and adoptee child. The adoption process remains restrictive for single-sex couples.
And the cost can be prohibitive. For example, the median fee in 2011 was $8,000 for the Dominican Republic, $15,355 in Panama and $26,063 in South Africa, according to the U.S. State Department's Intercountry Adoption Annual Report. Adoption fees for many of the 30-plus countries on the State Department's list are in the range of $20,000. That's not including travel costs.
Even so, international adoptions are often cheaper than domestic ones for newborn babies, which can cost $40,000 or more. To speed up the process, would-be adoptive parents should consider a school-age child, experts say.
According to the State Department, 233,934 international adoptions were made by Americans from 1999 to 2011. Nearly 94,000 of those adoptions involved children under the age of 1.
About 20,000 children age 3 or four 4 adopted during that period. And for kids ages 5 to 12, it was 29,712.
The benefit of adopting a school-age child is that it is easier to identify developmental and emotional problems ahead of time.
"There's more you can do to prepare and put resources in place to support what they need," Nish said.
School-age children can be challenging if pre-adoptive experiences affect their development, he said.
A special-needs child is also a possibility. One way to fast-track an international adoption may be to apply for a child with known medical or special needs, Montgomery said.
"For families with resources, it can be a great option," Montgomery said. "Of course, you really have to find the right family to take on that kind of known medical need."
Special needs can range from minor medical problems such as a cleft palate to more serious issues such as a heart condition, blindness or spina bifida.
"It's not about families getting a child quicker," Nish said. "It's about a family accepting a child into their household that they can provide for and love and nurture."
China's Waiting Child program, which includes children who have special needs or correctable medical conditions or are part of sibling groups, has wait times that are typically much shorter than the traditional program, according to Adoptive Families magazine. In 2011, more than half of adoptions from China were through this program. Would-be parents must be prepared to wait. The Associated Services for International Adoption, a nonprofit adoption group, says the wait time for an adoption referral in China is 73 months, as the country has clamped down on U.S. adoptions.
"If the wait time is becoming impractical, it's better to close the intake process" and start again, Cox said.
Tracy Downey and her husband, Jason, who live in suburban Des Moines, Iowa, tried to go the traditional international Chinese adoption route in 2006. But after waiting 18 months to bring home a baby from China, Downey switched gears and started combing the official Chinese list of children with special needs along with additional lists from adoption agencies and orphanages.
The Downeys adopted a daughter, Angel, and two sons, Corban and Tegan, from China, all with large, potentially disfiguring moles known as a giant congenital nevi. They started the process to bring home the two boys, now aged 3 1/2, last January. It took about 10 months.
Aside from their large moles, which are on the faces of two of the children and on the lower body of the other, all three kids are healthy and thriving, Downey said.
"If we wanted a non-special-needs child, we'd still be waiting," she said.