Avenues to Adoption

When Kellie and Paul Tasto walked down the aisle in 2007, they were already thinking about adoption. Three months before their wedding, Kellie learned that she had pulmonary hypertension (PH). She was critically ill with severe right heart failure, and she was devasted to learn that PH would affect their plans to start a family.

“I knew there was a greater risk of me or the baby not making it through a pregnancy,” Kellie recalls. “That just wasn’t a risk we were willing to take.”

Kellie, Grace and Paul

Carrying a child places increased stress on the heart and lungs. In women without PH, blood volume increases about 50%. For women with PH, the change in blood volume can lead to right-heart failure in PH patients whose right hearts are already overworked from the increased pressure in their pulmonary arteries. Some medications prescribed to PH patients also can be harmful to a developing fetus.

Some women with PH pursue adoption after consulting their PH physicians about family planning. Some couples go through private agencies, like Kellie and Paul. Others, like Lindsay and Jason Howe of Peoria, Arizona, become foster parents before adopting.

“Don’t let PH stop you from following your dreams and your heart’s desire,” Kellie says. “We ended up with the greatest blessing of our life, adopting our daughter.”

Saved by 'grace'

Kellie, 41, was diagnosed with PH when she was 28. She and Paul adopted their daughter Grace when she was an infant. The process took about two years. Soon after they completed their application, Kellie’s mom also was diagnosed with PH.

Today, her mother still faces PH challenges, but she enjoys time with Grace and four other grandchildren. "They're definitely the light in her days; they keep her pushing ahead," Kellies says.

“After we adopted and had Grace in our lives, it gave life so much purpose. It gave us so much joy. It made everything worth it.”

Today, her mother still faces PH challenges, but she enjoys time with Grace and four other grandchildren. “They’re definitely the light in her days; they keep her pushing ahead,” Kellie says.

PH and the placement process

Kellie and Paul began researching adoption agencies four years after they were married. They chose an agency in the Minneapolis-St. Paul area after weighing several considerations. Determining factors included length of the placement process, percentage of successful placements and cost.

Initially, Kellie was concerned her PH might prevent her from adopting. The screening process requires physical exams for prospective parents, with a doctor’s clearance. Kellie’s family and PH doctors wrote notes to confirm that she was in good health and her PH had stabilized.

Kellie and Grace

When social workers interviewed them during a home visit, they asked a few questions about PH to ensure Kellie was healthy enough to care for a child and had a good support system. In the questionnaire she filled out for birth mothers, she indicated that her lung condition prompted her to choose adoption.

“For someone with PH, it’s a lot to take on the responsibility of being a mom,” says Kellie, who says she is well and busy raising a 7-yearold. “Fortunately, I’ve had only a couple of hospitalizations since.”

Raising Arizonans

Lindsay, Jason, Hunter and Hailey

Lindsay and Jason Howe’s two-year journey to adopt biological siblings Hailey and Hunter began about four years ago when they moved to Arizona from California.

They applied for a license to become foster and adoptive parents to give them more options. The eight-month process included training classes, interviews and home inspections.

Lindsay, 37, worried the licensing agency, the Department of Child Services and the court might view her PH negatively. “I always feared that my licensing agency would Google and see the common prognosis as ‘terminal.’ While I have had PH for over 17 years, I knew those statistics were not entirely accurate, and I didn’t want them to assume my prognosis would be what is listed on an internet search.”

Lindsay and Hailey

Like Kellie, she needed a letter from her physician stating that she was well enough to become a foster/ adoptive parent. Her physicians from the UCLA Medical Center and her care team in Arizona supported her parenting ability.

Parenting with PH

In her paperwork, Lindsay described the support network to help her parent with PH: her husband, in-laws, parents, medical team, friends and neighbors. After they were approved and licensed, Lindsay’s PH didn’t come up again. “Licensing agencies work with families with all kinds of disabilities and limitations every day, and it’s best to be honest and forthright about your condition and your capabilities.”

“Foster care and adoption can be very mentally, physically and emotionally tolling for anyone, healthy or not,” Lindsay says. “It’s important that you have resources set up before you start any of these processes.”

Be realistic about what you can and can’t handle, and plan your resources for help in the short and long term, Lindsay advises. Be honest with everyone about how your PH affects your daily life, and express fears, concerns, stressors to your loved ones and your medical team. That way, they can help you throughout the entire process.

“Make sure your spouse or partner knows that when you have a ‘PH day’ that you will need some extra support,” she says. “Don’t be afraid to ask a family member or medical professional for some extra emotional support or physical help.”

Within three days of being licensed, Lindsay and Jason received a foster placement of an 18-month girl and her infant brother, who was born prematurely at about 30 weeks gestation. After a year of court proceedings and psychological assessments, they petitioned to adopt the children. The adoptions were finalized six months later.

“Every family-building avenue comes with its own type of stress … While it is stressful, the dream of holding a child you get to call yours can be accomplished.”