In 2013, Italy had the world’s highest international adoption rate among Western countries. Do adoption costs vary on the basis of characteristics of the adopted children? To answer this question, in 2015, 280 adoptive families took part in a detailed survey-the first of its kind in Italy-on their adoption experience. We describe the main results of the survey and draw first policy implications.

Introduction and research design

Adopting a child satisfies a desire for parenting and therefore affects the well-being of a family. As it has been noted, “International adoptive parents and children meet across lines of difference involving not just biology but also socio-economic class, race, ethnic and cultural heritage, and nationality” (Bartholet 2006, p.107). Italian families adopted 37,680 children between 2003 and 2013, with a rate of 6.7 international adoptions per 100,000 inhabitants in 2013, the highest among all Western nations. The US, the first receiving country in the world, welcomed over 170,000 children in the same period corresponding to 3.0 inter-country adoptions per 100,000 inhabitants in 2013 (CAI 2014).

Italian parents adopt children abroad because of the lack of a sufficient number of adoptable children domestically; in 2011, similarly to previous years, over 5,000 families applied for adoption but less than 1,100 children have been adopted domestically according to the Internal Affairs Minister (2012). The openness of Italian families toward adoption coincides with one of the lowest birth rates in the world (as reported in the last Italian census by ISTAT 2011).

Most of the empirical analyses available in the economic literature refer to the United States, which has not adopted the guidelines of the UN Convention on the Rights of the Child (1989), but ratified The Hague Convention on the international adoption of children in 2014. Its adoption procedure is composed largely of private agreements involving little state intervention. Thus, profoundly different procedures are followed among countries that have ratified The Hague Convention, as Italy has. The socioeconomic consequences of adoption in these countries are significant and deserve greater attention. Bennet Woodhouse (2014) has explored the differences and highlighted the unexpected similarities between adoption philosophies and procedures in Italy and the US. In the US, adoption is managed privately, while in Italy it is heavily state-controlled; Italian law focuses on children’s rights, while American law considers adults’ rights first. Americans choose the ethnicity and age of their adopted children, while by law Italians are not supposed to; however, “neither system is colour blind in operations” (Bennet Woodhouse 2014, p.9), and in fact Italian parents can choose the ethnicity of the adoptee by choosing to adopt through an accredited body operating in their area of interest. So in the end, Italian “adoptive parents can find ways to achieve individualistic and market driven results that we see in the US” (Bennet Woodhouse 2014, p.9).

The Italian adoption authority does not disclose information on either adoptive families or unsuccessful adoptions, so the data were gathered through a survey of Italian adoptive families. We describe the costs associated with the adoption procedure (accredited body fees, health care, and travel costs), the characteristics of the adopted children (age, continent of origin, disability, and gender), and the characteristics of the adoptive parents (age, education, and income).

Given the lack of cooperation by the Italian authorities in the research, the anonymous questionnaire, which was conducted from 15 December, 2014, to 10 August, 2015, was posted on Survey Monkey and advertised through adoption newsletters, blogs, forums, press articles, a Facebook marketing campaign and two interviews on national TV with the principal investigator. Interested parents were directed to a secure URL, where they were supplied with details regarding the survey.

The questionnaire was formulated on the basis of existing literature, is similar to the questionnaire submitted by the CAI to Italian adoptive families after entering the country with their adoptee, and comprised 59 questions divided into seven sections, beginning with a filter question: “Have you adopted one or more children abroad?” The questionnaire’s seven sections are outlined in Table 1.

Table 1. Questionnaire structure
Section Issues
I. Adoptive family data age, education, income, number of adoptees, adoption duration
II. Information and support information and support from social services, accredited bodies
III. Characteristics of the adoptive child child age, country of origin, presence of needs
IV. Period spent abroad duration and satisfaction, parental leave after returning to Italy
V. Post-adoption period support from social services and accredited bodies
VI. Current family situation satisfaction with the adoption, child’s requests and needs
VII. Adoption costs accredited body, travel, information, health care

In the first section of the questionnaire, families were asked to provide socio-demographic information (age, level of education, income, and number of adopted children) and the duration of their adoption. The second section addressed the support provided by public social services and accredited bodies as well as the perceived satisfaction before the child arrived in the family. The third section was devoted to the adopted child and the child’s characteristics (age, gender, special needs, birth country). The fourth section asked about the time spent abroad with the child (duration and satisfaction) and the parental leave taken after returning to Italy (how long parents were away from work after returning to Italy). The fifth section asked about the support provided by public social services and accredited bodies as well as the satisfaction with this support after the child joined the family. The sixth section examined the current family situation and asked about the satisfaction of the adoptive experience, the extent to which parents felt that the child was aware of his/her story, and his/her relationship with other family members (aunts, grandparents) and school. In the final section, families were asked about cost of their adoption (fee for the accredited body, health-care treatments, and other expenses) and whether these expenses were as expected.

Parents and children

Among the 280 respondent families, 63% had adopted one child, 34% had adopted two, 3% had adopted three, only one family had adopted four and no family had adopted 5 or more children; 66% of children were male, and over 60% of the adoptions reported had taken place after 2010. The survey confirmed that adoptive families are self-selecting in terms of their education and income; over 50% of families had a monthly net income over €3,000, whereas the national average is €2,500. The adoptive families in the survey came mostly from northern and central Italy.

The adopted children in the survey came from Asia (32%), Africa (27%), Europe (22%) and Latin America (19%). The ages of the children proposed to families depended on the laws in the home countries and any limitations in the Juvenile Court’s decision for the adoptive parents. Indeed, age distribution is correlated with the continent of origin: Asian and African children were younger than their European and Latin American counterparts. 47% of the children in our survey were younger than the age of 3 at the time of the adoption, 20% were 3-5 years of age, 30% were 5-9 years of age and only 4% were older than 9 years of age. able 2 shows the descriptive statistics of selected variables.

Table 2. Summary statistics of variables
Variables Obs. Mean S.D. Min Max
Number of adoptees 244 1.377 0.606 1 4
Child gender 238 0.655 0.476 0 1
Adoption duration 237 3.330 1.620 1 8
Mother's age 237 40.721 4.999 27 56
Father's age 237 42.139 5.125 26 61
Satisfaction with adoption 200 9.380 1.201 1 10
Note: Child gender is =1 if male; is =0 if female; adoption duration is the waiting period expressed in years (from 1 to 8); mother's and father's age when the adoption took place; satisfaction ranges from 10 (max) to 1 (min).

Adoptions’ costs

In contrast with procedures in the US, adoption in Italy takes several years. The wait endured by the adoptive families in our study after they had obtained the positive decision of the Juvenile Tribunal was less than two years in only 35% of cases. An additional 30% waited for three years, 15% waited for four years, 10% waited for five years, 4% waited for six or seven years and 3% waited for eight years or more. During this waiting period, families mostly looked for information on adoption, on the country of their prospective child, and joined volunteer groups for adoptive families. Among these activities, families reported that it was helpful to get information about the country and meet adoptive families with children from the same nation as their prospective child.

Contrary to The Hague’s recommendation, the CAI does not provide updated data on the adoption costs incurred by Italian families. In our survey the families were asked to evaluate the costs associated with their adoptions, which are accredited body fees, travel, information (including language tuition and translation), health care expenses in Italy and health care expenses abroad. Families referred that the most significant cost was the fee of the accredited adoption body, followed by travel expenses. Families spent less than €7,000 on accredited body fees in only less than 35% of cases, while they spent less than €7,000 on travel expenses in 75% of cases. The expenses incurred for information, health care costs in Italy and health care abroad amounted to less than €3,000 in 90% of cases. Over 80% of families reported not being surprised by the overall adoption costs. These results further confirm that adoption is expensive for a family, so that adoptive families are self-selected.

Respondent families travelled abroad for their adoption for a period between 8 and 22 days in 40% of cases; in 47% of cases, the families travelled for a period between 23 days and 2 months. Most importantly, over 70% of respondent families were very happy with the overall experience, rating their satisfaction between 8 and 10.

Table 3 Adoption's Costs

Up to €3,000




Over €30,000

Accredited body












Children health care (foreign country)






Parnets' health care






Children health care (Italy)






Home, car and other expenses






Information (language, guide)






Source: Survey data (2002-2014).


Despite the self-selection of the sample and the resulting impossibility of generalizing the results, the survey on the inter-country adoption of children by parents in Italy provides useful indications on this specific-research topic. The reduction of health care and social services public spending limits the number of children with special needs that can be treated in the country, increasing the risks of adoptions’ disruption; for this reason, the number of children with special needs available for adoption, that increased steadily after 2010, should be reduced by accredited bodies.

Families wishing to adopt a child should be adequately informed about the challenges and risks of this parenting experience. The Italian adoption system is complex and slow, but has achieved to form an incredible number of happy families; the selection process and the screening by the social services and the Juvenile Courts seem to work well. Today adoption in Italy is limited to same-sex married couples, leaving out single parents, same-sex and un-married couples. Policy makers should consider the opening of adoptions to these other forms of (happy) families, following the experience of other European countries (e.g. France and Sweden) since there is no evidence in the literature of a different or reduced ability to welcome a child.


Bartholet E (2006) International adoption. In: Lori Askeland (ed.) Children and youth in adoption, orphanages, and foster care. Westport (CT): Greenwood Publishing Group Inc.

Bennet Woodhouse B (2014) Inter-country adoption in Italy and the United States: divergent approaches to privatization, discrimination and subsidiarity, Legal Studies Research Paper Series n. 12-233, Emory University School of Law.

Commissione per le Adozioni Internazionali (CAI) (2014, 2013, 2012, 2011) Data and perspectives in inter-country adoptions … Report on files from January 1 to December 31, 2013, 2012, 2011, 2010. Florence: Istituto degli Innocenti.

European Parliament (2009) International adoption in the European Union. Brussels.

ISTAT (2011) 15th Italian Population and Housing Census. Rome.

Skidmore M, Anderson G, and Eiswert M (2014) ‘The child adoption marketplace: parental preferences and adoption outcomes’, Public Finance Review. DOI: 10.1177/1091142114547412

The Hague Conference on Private International Law (2014) Notes on the financial aspects of inter-country adoption. The Hague.

United Nations (1989) Convention on the Rights of the Child. Washington D.C.

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