I will rely on a fair amount of data to discuss what I see as the significance of international adoption. However, I want to begin with a single number that will put the rest of this essay in context: the World Health Organization reports that more than ten million children under five years old – most of them in developing countries – die each year from violence, malnutrition or disease.¹

Ten million is hard to comprehend. Nor is it any easier if we break it down: thirty thousand children each day; more than one thousand every hour. Every day, the toll of children's lives equals ten times the number who died in the World Trade Towers, and each week matches the total of fatalities in the 2004 Asian tsunami. Deaths equaling fifty tsunamis each year – a number that has not budged much in a decade, by the way – but sadly, to quote an op-ed piece published years ago by A. M. Rosenthal of the Times, it is not news.

In the long run, all international humanitarian intervention – medical assistance, constitution-making, adoption and in-country development – is propelled by that number ten million, by the desire to help some of those children find the stability and the health and the homes that will enable them to survive, and perhaps even to flourish. The fact that many of those efforts fail does not subtract from the need to remain engaged.

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Adoption is among the oldest and most widespread of human social practices. The Code of Hammurabi, promulgated in the 18th century BCE, includes a definition of adoption.² Scores of other literary and historical texts document that, in one form or another, for a variety of motives, and with an equally diverse set of outcomes, orphaned and abandoned children have circulated among families throughout human history.

Children have been adopted, legally and extra-legally, formally and informally, to constitute or re-constitute families, to provide homes when birth parents could not or would not do so, to serve as slaves, on the one hand, or to replace disinherited or deceased heirs on the other.

In his path breaking book, The Kindness of Strangers, John Boswell uncovered a previously hidden history, tracking the lives of children abandoned in Europe from the late classical through the early modern periods. Boswell concluded that children were abandoned in large numbers, but rarely with the intention of infanticide. Instead, many societies developed protocols – rarely written down but universally understood – for the orderly circulation of children: from families who, for whatever reason, chose or needed to give up a child to families who, again for all the reasons mentioned above, wanted to add a child. Boswell's data (incomplete, to be sure) suggest that mortality rates for abandoned children were probably about the same as for children who remained in intact families.

The European story continued in the New World. While adoption in Colonial America can be traced back to the early years of white settlement, the practice was long governed informally and on an ad hoc basis. Relatives, sometimes neighbors without legal authorization, took in abandoned children or those who lost their parents. In the 18th and 19th centuries, less fortunate children could find themselves marooned in "poor houses" or orphanages, often until their 16th birthdays. In 1851, Massachusetts enacted the first modern adoption law, which recognized adoption as a social and legal matter requiring state supervision.

If 1851 was late in the history of adoption, it was actually early in the history of adoption law. The United Kingdom, for example, did not enact legislation regulating adoption until 1926. Some historians of adoption have argued that the practice may have seemed more compatible with American cultural assumptions than with those of other countries. Families created by choice rather than biology, that is to say, enact a process that perhaps rhymes with our democratic professions.