Private domestic infant adoption in the United States is a multibillion-dollar industry shaped by a painful imbalance: far more prospective adoptive parents are seeking infants than there are infants available for adoption. In that environment, a loosely regulated network of agencies, consultants, and unlicensed intermediaries has grown around the country.
Critics call some of those intermediaries baby brokers. They recruit pregnant women, often facing poverty, housing instability, or isolation, while offering hopeful families the prospect of a quicker adoption. The result is a system in which money, travel, housing, legal consent, and emotional crisis can become deeply entangled.
Reporting by FRONTLINE and Retro Report examines how Utah became an epicenter for what has been called adoption tourism, why advocates say women are being brought across state lines into more vulnerable circumstances, and why adoptive parents have also raised alarms about the process.
How adoption tourism works
Adoption tourism is the practice of moving an expectant mother, adoptive parents, or both to a different state in order to complete an adoption under that state’s laws. In Utah, agencies have historically been able to work with women and families from around the country, while the state’s adoption laws made consent difficult to revoke once signed.
The business often begins with online advertising. A woman in financial distress may search for adoption help, housing, or assistance with bills. Paid search results can steer her toward an out-of-state agency instead of a licensed local provider that may be better positioned to connect her with services in her own community.
Kelsey VanderVliet Runyard, who works with a nonprofit tracking adoption advertising, described how searches from different parts of the country repeatedly surfaced paid ads from Utah agencies. In some cases, she said, the advertisements were connected not directly to agencies but to unlicensed intermediaries whose role was to persuade women to relocate and then hand them off to an agency after arrival.
That arrangement can reverse the traditional idea of adoption. Rather than locating families for children who need them, the private domestic infant adoption market can become a competition to locate infants for families who want them. Critics argue that this incentive makes the process transactional and raises the risk that financial hardship is treated as a pathway to placement.
Tia Gowans and the consequences of a rushed decision
Tia Gowans was 20 years old, living in Michigan, and facing homelessness as winter approached when she began considering adoption for her three-month-old daughter. Having been adopted herself, she searched online for adoption agencies and called the first result that appeared.
Gowans said the woman who answered, Flossie Green, offered her $1,000 if she completed an adoption. Within a day, she and her baby had been flown to Salt Lake City, where she was introduced to Sandy Quick, owner of Ryder Adoptions, and to an out-of-state couple hoping to adopt.
That night, Gowans said she began to doubt the decision and asked to go home. The following morning, she said, the agency presented adoption paperwork. She described being told that the documents would be read aloud and that she should sign where she was directed.
At the time, Utah did not offer birth mothers a post-consent revocation period comparable to the 30-day reconsideration window available in some states. Gowans said the entire sequence, from her arrival in Utah to the completed placement, took three days. Before she left, she said she received $4,000 in cash.
Quick declined an interview. In a prior email, she said her agency took any sign of hesitation seriously and would not accept consent from a mother who did not fully understand the consequences. Green and Quick were not charged with crimes or barred from operating in connection with Gowans’ account.
The story illustrates a central question running through adoption reform debates: when does pregnancy-related support become an inducement to relinquish a child?
Cash payments, housing offers, and the line between help and coercion
Adoption agencies can legally provide pregnancy-related support in many states. That can include housing, food, clothing, transportation, medical care, counseling, legal support, utilities, and phone expenses. The law prohibits buying or selling a child, but the practical boundary can be difficult to define.
Donna Pope, who operates the nonprofit Heart to Heart Adoptions in Utah, argued that women in crisis deserve meaningful support during pregnancy. She said an agency should treat women with dignity, respect, and empowerment, and should help them access the services they need.
But advocates and some adoptive parents said lump-sum cash payments, particularly after placement, can feel fundamentally different from direct help with necessary expenses. One adoptive mother who had completed an adoption in Utah said the process had seemed easy at first, but later came to see that ease as a warning sign rather than proof that everything had been ethical.
She recalled receiving information about a pregnant woman who had placed children for adoption in 2020 and 2021 and was considering another placement in 2022. To her, the repeated placements suggested not support, but a lack of access to stable housing, health care, contraceptives, and longer-term assistance.
She and her husband ultimately chose to pursue adoption through an agency in their home state of Georgia. Her concern was not that support should be withheld from pregnant women. It was that support should never be structured so that placing a child appears to be the only viable way to survive.
Why moving women away from home can increase vulnerability
Utah became a major destination for adoption tourism partly because agencies offered travel, apartments, medical care, and living expenses to women from other states. Those offers may sound like relief to someone who has nowhere else to turn. But relocation can also remove a woman from the people and institutions most able to help her make a fully informed choice.
Advocate Ashley Mitchell, who placed a child for adoption herself, documented reports from women housed in apartments connected to adoption agencies. She said women described fearing they would be evicted if they chose to parent rather than place.
One woman who had traveled to Utah after responding to an online ad said she had been promised an apartment, medical care, food, and clothing. As the pregnancy progressed, she began reconsidering adoption but felt scared to say so. She described feeling trapped, isolated, and unsure whether she would owe money if she changed her mind.
With help from advocates, she returned to her home state with her newborn. Six weeks later, she again contacted the adoption agency for assistance and ultimately completed an adoption. She later said the agency provided $5,000 through cash apps and gift cards. The agency owner disputed her account and declined an interview.
For critics, the issue is not merely the distance traveled. It is what that distance can do to a person’s choices. A woman who leaves her job, family, friends, local health providers, and community supports may be left with an impossible calculation: return home without resources or follow through with an adoption plan.
Concerns from hospitals and child welfare providers
Tara Romney Barber, a program director at a Utah nonprofit child welfare organization, argued that adoption services exist in every state and that women should be able to receive support without being separated from their natural support system.
Her organization works with only a small number of adoptions and does not recruit mothers from out of state. She raised concern that women brought to Utah may not know their rights and may believe they must repay medical or housing expenses if they decide to parent.
A hospital employee who became concerned about the number of out-of-state adoptions reported the issue to the Utah Attorney General’s Office. The report named adoption providers and said some women had mental health challenges or told hospital staff they felt pressured to sign paperwork. It also cited an instance in which twins were separated.
Such accounts helped fuel legislative hearings in Utah during 2025. The core concern was not whether adoption should exist, but whether the system was protecting every person involved during an intensely vulnerable moment.
Utah’s adoption reforms and what remained unresolved
Utah lawmakers considered reforms that would give mothers 72 hours to revoke consent, require agencies to register as nonprofits and disclose where they are licensed, and guarantee access to mental health therapy for birth mothers.
By March 2026, the legislature had passed the proposed reforms. However, it left in place a controversial policy that makes it difficult to undo an adoption, even in cases involving alleged fraud.
Sandy Quick defended her practices during legislative testimony, saying neither she nor her agency had done anything illegal or unethical. She said confidentiality restrictions had prevented her from responding fully to media reports.
The broader challenge is that regulation can change faster than the underlying financial pressures. Prospective parents may be desperate to adopt after years of infertility treatment. Pregnant women may be desperate for housing, safety, and stability. Agencies and intermediaries may be positioned between those needs, collecting substantial fees while controlling information and access.
Adoptive parents can also be harmed by an opaque system
The consequences of weak oversight do not fall only on birth mothers. A couple from Tennessee said they paid $45,000 toward a total expected adoption cost of $78,000 while working with Quick’s agency. They said they used a home equity line of credit and sold 3½ acres of land to raise the money.
They said they did not receive an itemized accounting or receipts explaining how the money was used. Under Utah law, adoption expenses are supposed to be documented and submitted to a court. A state audit found that Quick did not submit expense reports in a timely manner for roughly 75% of her adoptions between 2024 and 2025.
Before their planned placement was completed, the couple received an email saying the agency was closing because of what Quick described as a changed legal landscape. They said they were left without answers about their money, the expectant mother, or the future of the adoption plan. Along with other families, they filed complaints with the state attorney general’s office.
For people trying to build a family, the emotional stakes can make it harder to question an arrangement that feels rushed or unusual. A fast match, a request for a large immediate payment, or a lack of detailed records can be treated as obstacles to overcome rather than warning signs to investigate.
The Marshall Islands case exposed the stakes of cross-border recruitment
The concerns surrounding adoption tourism did not begin with Utah agencies recruiting women from other U.S. states. One of the most consequential cases involved attorney Paul Petersen, who brought pregnant women from the Marshall Islands to the United States and arranged adoptions for American families.
Petersen had spent time in the Marshall Islands as a Mormon missionary before becoming a lawyer and launching an adoption business. He later expanded operations into Arkansas and Utah, where the adoption process had fewer barriers.
Dan and Rachel Christensen hired Petersen in 2018 after being referred by a friend. They expected the process to take a year or more. Instead, they received a match notice within three weeks and were asked to wire $24,000 within days.
The couple met the expectant mother, Telma, in Utah. They were troubled to find her wearing flip-flops and light clothing in snowy February weather. At a prenatal appointment, they learned that the visit appeared to be her first, despite assurances that she had been receiving medical care. The baby had to be delivered urgently because of serious health concerns.
After the birth, the Christiansens visited the house where Telma was staying and found numerous pregnant women sleeping on the floor. Rachel Christensen said it felt like a baby mill. The couple reported their concerns to Utah authorities.
Investigators found that dozens of pregnant Marshallese women had come to Utah, often with the same address and Petersen’s name listed in paperwork. Hospital staff had also raised concerns that some women, communicating through translators, did not understand what was happening.
The investigation uncovered a multimillion-dollar operation involving unlicensed middlemen who recruited pregnant Marshallese women with promises of money and better opportunities for their children. Some women said they had not received the full amount promised and had expected continued contact with the children after placement.
Investigators concluded that cultural misunderstandings were exploited. In Marshallese culture, extended family members commonly participate in raising children. Several women appeared not to understand that adoption paperwork meant permanently surrendering parental rights.
Petersen was arrested in 2019 and ultimately pleaded guilty to state and federal charges, including fraud and human smuggling. He received a sentence of more than 10 years.
Why a patchwork of state laws creates gaps
The Petersen case demonstrated how conduct that may appear plainly harmful can still be difficult to prosecute. Investigators and prosecutors must determine which laws apply, what happened in each state, whether payments were lawful support or unlawful inducements, and whether false statements meet the legal standard for fraud.
Former federal prosecutor Clay Folks said no one may pay cash to induce a pregnant woman to place a baby for adoption, and no one may be paid to seek out vulnerable people for that purpose. Yet the system often operates in gray areas, where the ethical line can be interpreted differently by agencies, lawyers, and state regulators.
In Arkansas, advocates continued to receive calls from families who felt preyed upon and from hospitals concerned that a mother did not want to proceed with a planned adoption. One case involved a Marshallese woman who did not speak English and said she had been forced into an adoption by relatives. Advocates helped her seek to vacate the adoption on the basis that she had signed documents she did not understand.
Her case was eventually dropped after she missed a court date and became unreachable amid homelessness and ongoing crisis. It was a devastating example of how the people most in need of legal protection may be least able to sustain a long court fight.
The case for federal adoption standards
International adoptions involve federal and international standards. Domestic infant adoptions, by contrast, are governed primarily through 50 sets of state laws. Advocates, investigators, and lawmakers argue that this inconsistency enables agencies and intermediaries to move people toward states with fewer protections.
A bipartisan federal proposal supported by lawmakers from more than a dozen states would target unlicensed intermediaries who market to pregnant women and prospective adoptive parents across state lines. Its aim is to reduce solicitation and prevent families from being transported to a state where they may face weaker safeguards.
Supporters of federal action do not necessarily argue that the federal government should take over adoption entirely. They argue for a national baseline: clear rules around advertising, licensing, expenses, informed consent, counseling, documentation, and the use of intermediaries.
That baseline could make it harder for a vulnerable woman to be recruited far from home, harder for prospective parents to be charged large unexplained fees, and harder for brokers to profit from gaps between state systems.
An ethical adoption system must protect everyone involved
Adoption can be rooted in love, loss, hope, and genuine care. The problem exposed by these cases is not that every agency, adoptive parent, or adoption plan is unethical. It is that a system built around scarcity and high financial stakes can create conditions where urgency overrides informed consent and desperation becomes a business opportunity.
For birth mothers, meaningful protection means independent legal advice, accessible counseling, transparent information, stable support that is not contingent on placement, and enough time to make an informed decision.
For adoptive parents, it means full financial transparency, clear records, ethical recruitment practices, and confidence that a placement was not shaped by coercion or misinformation.
For adoptees, it means knowing that the beginning of their story was handled with dignity and honesty, not under the shadow of exploitation.
For additional reporting and documentary resources, visit the FRONTLINE Baby Brokers page.
Credit
This article is based on reporting from FRONTLINE PBS | Official and Retro Report. Full credit goes to FRONTLINE PBS | Official for the original documentary, Baby Brokers, reported by Gabrielle Glaser.
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