In 2007, moviegoers enjoyed Juno, a film about the misadventures of a pregnant high school student, who, after wisecracking her way through nine months in ninety-six minutes, places her son for adoption.

If we could follow the film’s eponymous heroine off-screen after the credits roll, what would Juno tell us about her adoption four years later? Research suggests that her life has not been as uncomplicated and filled with carefree bike-rides and catchy guitar playing as the final scenes would have us believe. 

Last week, President Obama proclaimed November as National Adoption Month, which seems nearly routine—these days, November is always given this distinction. However, the idea of a month dedicated to adoption awareness was something that could not have taken root a generation ago, when adoption was still mired in secrecy.

Adoption has an abysmal and embarrassing history in the United States. The twenties saw Orphan Trains, where children (many of whom weren’t actually orphans) were placed into what frequently amounted to indentured servitude. The thirties and forties marked the emergence of for-profit adoption following the lead of the terribly corrupt Georgia Tann, who actively stole children from poorer families and placed them with anyone able to pay her high fees. The fifties and sixties constituted the “baby scoop” era, where young pregnant women were sent to maternity homes and subjected to emotional and financial coercion that denied their motherhood and assured them they would forget about their children soon after the adoption.

They never did.

From this history of corruption emerged the tenets that would shape adoption for following generations: a large amount of secrecy, an unhealthy dose of shame, and the belief that keeping adoptions closed was the best thing for all parties.

Today, having seen the problems closed adoptions can cause—regret and trauma on the part of birth families, and an unfulfilled need to know their origins and history on the part of adoptees—open adoptions are becoming more and more of the industry standard. Openness, however, can mean many things: perhaps the birth parents select the adoptive parents and have little communication after the child is born; perhaps formal letters with pictures are exchanged once a year; perhaps both sets of parents consider the others friends and feel comfortable picking up the phone whenever they’d like to chat. Whatever form openness takes, though, it isn’t simple.

I have interviewed women who placed children up for adoption over the past 50 years and in 30 different states; the women ranged from 14 to 42 years of age at the time of the adoption. Some were coerced into adoption against their strongest wishes; some freely chose it as the best available option. Some are active anti-adoption advocates; some work as pro-adoption counselors at the agencies where they placed their children. Some have not seen the child they gave birth to since leaving the hospital many decades ago. Some babysit for their child every few weeks.

As a group, these women agree on almost nothing, except that adoption is harder and more complicated than most of society believes it to be. The one thing they do share is this: none of the women I’ve interviewed wanted less contact than they had with their child (even those who had initially wanted a closed adoption), and many wanted more.

Yet, even as openness becomes more common within adoption communities, it remains misunderstood. Adoptive parents have told me they frequently feel the need to defend their child’s birth parents to friends and relatives who don’t understand the reason for their continuing relationship, or who see the presence of a birth mother as a threat to the bond between adoptive mother and child. Even among those who are more accepting, there is often a belief that openness is in place only as a favor to the birth parent. In truth, it offers benefits to all parties. Openness can increase the stability of the adoptive family by removing secrecy and shame, it can reduce the natural questions the child may have about where they’ve come from, and it can expand the kinship circle available to the adoptee as they grow.

While openness is beneficial, it’s rarely easy: one young birth mother I spoke with told the story of how she and her son’s adoptive parents agreed on the number of annual visits and the idea of openness in general, yet while she viewed their family as an extension of her own, they continued to see her as someone separate from their family unit. This difference created tension that was understandably upsetting; she referred to it as “a second loss” (the first, of course, being the adoption itself).

Fully embracing openness is key to our efforts to keep improving adoption and placing further distance between its dark and coercive past and its hopeful future. Many of the historical problems with adoption came from the desire to keep it secret, to allow adoptive families to “pass” as traditional, biologically related families. Now, society is becoming more accepting of many types of non-traditional families, finding ways to address their diverse needs and broadening definitions of what truly makes a family. In his Adoption Month proclamation, President Obama specifically stressed the importance of ensuring that “all qualified caregivers are given the opportunity to serve as adoptive parents, regardless of race, religions, sexual orientation, or marital status.”

Yet, within these inclusive narratives, it’s important to recognize families living in open adoption (including birth parents) as similarly worthy of attention and support after the adoption is completed. When it comes to adoption, acceptance requires an understanding of openness as a ongoing, lifelong process that respects the rights and needs of birth parents, adopted people, and adoptive families alike.