She cited the situation in Cambodia in 2001, when officials said they had found evidence of child trafficking, with corrupt middlemen profiting from the adoption of children whose parents had not consented to them being adopted. In some cases, the birth parents had left the children at an orphanage temporarily with plans to recover them when their financial situation improved, while the adoptive families were unaware that the children were not actually orphans.
Advocates of reform say the Cambodia crisis shows a need for greater regulation of the international adoption process, while many adoption advocates say there is no evidence that trafficking is widespread, and existing international standards are sufficient to prevent potential abuse. They also warn that children living in orphanages face significant risks of trafficking and abuse in their own countries.
Under Maskew's leadership, the State Department proposed new regulations, including a new "country-specific authorization," increased training requirements for adoptive parents, and additional oversight of adoption agencies and the service providers they work with during the adoption process.
In late 2017, the Council on Accreditation announced that it was withdrawing from its role as the sole U.S. international adoption accrediting entity. The council cited new requirements at the State Department which it saw as being "inconsistent with [its] philosophy and mission."
A new accrediting organization was created – the Intercountry Adoption Accreditation and Maintenance Entity (IAAME) – which began implementing new regulations and fees.
IAAME maintains that ensuring compliance with federal regulations is necessary to ensure that adoptions are conducted ethically.
"There have been instances of trafficking of children within intercountry adoptions," IAAME Executive Director Kim Loughe told CNA.
"With the safety of children, adoptive families, and biological parents as our top priority, IAAME works with adoption service providers to ensure intercountry adoptions take place in the best interest of children," she said.
"In doing so we work to prevent the abduction, exploitation, sale, or trafficking of children."
However, critics argue that the regulations are so strict that they impose unrealistic burdens on other countries, and fail to accommodate for their lack of resources to meet these requirements.
In some countries, such as Nigeria, birth certificates are not created until they are needed for legal purposes. A Nigerian birth certificate, not registered at the time of birth, is disallowed by U.S. regulations, despite the explanation given for discrepancy, Warnock said.
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"They're imposing U.S. standards on countries that don't have those kinds of practices in place. How can families meet that requirement? They can't. And then they're stuck," she said.
Warnock acknowledged that there could be better educational outreach for some facilities that do not have a good record-keeping system.
"We would hope that record-keeping would be better [in some of the international orphanages], but there is still no evidence that, despite certain gaps in the record-keeping, that children are being trafficked," she said.
"I also know that these orphanages are just struggling to make ends meet," she said. "And for them to hire the administrative or social work staff to meet the enormous amount of bureaucratic requirements, it would be impossible."
A State Department official told CNA that intercountry adoption is a high priority for the department, but preventing harm and corruption is an essential part of working to support adoption.
The official noted that the department's Office of Children's Issues created a bilateral engagement division earlier this year to focus on relationships with foreign partner nations and expanding intercountry adoption opportunities. In July, the department announced that it had begun discussions with Vietnam on a plan to expand adoptions by U.S. families, which are currently only permitted for children with special needs, children over age 5, and sibling groups.