Adoption is the legal act of permanently placing a child with a parent or parents other than the birth parent or parents. A decree of adoption severs the parental responsibilities and rights of the biological parent or parents and places those responsibilities and rights on the adoptive parent or parents. Following a decree of adoption, there is generally no legal distinction between biological and adopted children. Adoption establishes the adoptive parents as the new legal custodians and legal parents of the child.

In North Carolina, adoptions may be by direct placement with the adoptive parents by the biological parent or parents or by placement with the adoptive parents through a licensed adoption agency or Department of Social Services. North Carolina law also recognizes stepparent adoptions and adult adoptions. North Carolina law does not recognize second parent adoptions, that is, an adoption that does not sever the rights of the biological parent, such as a same-sex adoption. There is no right to adopt a child in North Carolina. The focus of the court in any adoption proceeding is the best interests of the child.

Adoptions occur for many reasons. Many unwed mothers are placed under significant familial or religious pressure to place a child who is about to be born for adoption as an alternative to abortion or single parenthood. Sometimes biological parents decide that they are unable to adequately care for their children, so they place them for adoption. In some countries, single motherhood is considered scandalous or unacceptable, so women often make an adoption plan for their infants. In other countries, mothers are placed under financial, societal or familial pressure to choose adoption. In some cultures, such as China, a parent or parents prefer one gender over another and may place any baby who is not the preferred gender for adoption. Some biological parents involuntarily lose their parental rights. This may occur when a child is abused, neglected, or abandoned. Eventually, if the parents cannot resolve the problems that caused or contributed to the harm caused to their child (such as in cases of alcohol, drug abuse, or domestic violence), a court may terminate their parental rights and the child may then be placed for adoption.

The main reasons that a person or couples seek to adopt vary, depending largely on social and legal structures. The inability to biologically reproduce is a common reason, often due to infertility. Another obstacle is the lack of a partner of the opposite sex or a lack of desire to use a surrogate or sperm donor. Singles and same-sex couples often adopt for this reason. Step-parent adoption is the most common form of adoption. Following the divorce or death of one parent, a parent may desire a fresh start for a child with a step-parent. Certain jurisdictions prohibit same-sex couples from adopting a child. The preference given to opposite-sex couples is largely due to the perception that such couples are seeking to adopt because of fertility problems, and therefore should be given preference on medical grounds. Adoption by couples in same-sex civil unions or marriages are allowed in Australia, Belgium, Canada, the Netherlands, Spain, Sweden, the United Kingdom, and the United States in the states of California, Massachusetts, New Mexico, New Jersey, New York, District of Columbia, Vermont, Washington and Wisconsin. Some jurisdictions allow adoption by same-sex couples where the adoption is a stepparent adoption, i.e. where one of the partners in the relationship has a child or children of her or his own. Such limitation exist in Denmark, Iceland, Norway, France and Germany. Ireland does not allow joint applications to adopt from same-sex couples, but does permit applications from one of the partners.

Because of the unavailability of children to adopt in the United States, many couples have used international adoption as a means of adopting a child or children. The laws of different countries vary in their willingness to allow international adoptions. Some countries, such as China and Vietnam, have relatively well-established rules and procedures for foreign adopters to follow, while others, such as the United Arab Emirates (UAE), expressly forbid it. Some countries, most notably several African nations, have extended residency requirements that in effect rule out most international adoptions. Some countries have been closed to adoption altogether. In 2005 the most common countries for international adoption by parents in the United States were China (7,939), Russia (4,652), Guatemala (3,748), South Korea (1,604), Ukraine (841), and Kazakhstan (755). Other less common countries include Bulgaria, Colombia, Ethiopia, Haiti, India, Philippines, and Poland. Vietnam recently signed a treaty openings its doors for adoption. In China the girls that are adopted far outnumber the boys. This is due to the Chinese culture's son preference in combination with the official planned birth policy implemented in 1981. About 95% of Chinese children adopted are girls. Although India also has a noticeable excess of girls being adopted (68% girls), most other countries are about even. In South Korea about 60% of the children adopted are boys. This is a switch from the 1980s, when about two-thirds of Korean adoptees were girls. In many cases, international adoptions are finalized once the foreign child comes to live with her or his adoptive parent(s) in North Carolina.

Recognizing some of the difficulties and challenges associated with international adoption, and in an effort to protect those involved from the corruption and exploitation which sometimes accompanies it, the Hague Conference on Private International Law developed the Convention on Protection of Children and Co-operation in Respect of Intercountry Adoption, which came into force on May 1, 1995. The main objectives of the Convention are: (1) to establish safeguards to ensure that intercountry adoptions take place in the best interests of the child and with respect for her or his fundamental rights as recognized in international law; (2) to establish a system of co-operation amongst Contracting States to ensure that those safeguards are respected and thereby prevent the abduction, the sale of, or traffic in children; and, (3) to secure the recognition in Contracting States of adoptions made in accordance with the Convention. To date, this Convention has been ratified by 70 countries. Several more countries are signatories to the Convention and are at various stages in taking steps to achieve full ratification.

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