Bethany and Kevin Durkin hold their daughters Olivia, 7, left, and Lucy, 5, March 13 in their in Katonah, N.Y,. home. The Durkins are part of a growing number of parents who have adopted special-needs children from China. Olivia had a weak, underused right arm when she was adopted in 2004, while Lucy had a cleft palate that was repaired through surgery soon after her adoption in November 2007.

New York ? Not long ago, the choices facing Robert and Julie Garrett would have been simpler. Once they set their hearts on adopting a child from China, the odds were high they could soon bring home a healthy infant girl.

It’s different now.

Faced with a long wait — and a smaller pool of healthy orphans available to foreigners — the Garretts have decided after much soul-searching to adopt one of the special-needs children who now abound in China’s orphanages.

“It’s really hard, and we want to make the right choice,” said Julie Garrett, of Gainesville, Ga.

The children’s conditions range widely. Some are correctible, some not: cleft lips and palates, congenital heart disease, missing or malformed limbs, impaired vision or hearing.

“It’s important for us to not take on more than we can handle,” Garrett said. “That process takes time — praying over it, discussing what medical needs you think you could take on.

“It’s a journey in itself just to decide if that’s the right direction to go.”

Special-needs adoptions

Starting in the early 1990s, and as recently as a few years ago, the large majority of Chinese children adopted by foreigners were healthy baby girls abandoned by their parents, often because of a preference for a son in a country rigidly enforcing a one-child policy.

Between 1995 and 2005, Americans adopted more than 60,000 children from China. The peak was 7,903 in 2005.

Circumstances have changed dramatically since then. China has eased its one-child policy, fewer baby girls are abandoned, domestic adoptions of healthy orphans have increased, and the waiting time for foreigners to adopt a healthy infant has tripled to roughly four years.

As a result, U.S. adoptions from China have plummeted more than 60 percent, to 3,001 last year. And of the children now adopted, roughly three of every five have special medical needs.

One contributing factor is China’s rate of birth defects, which a government family planning commission said increased by nearly 50 percent between 2001-2006.

Amy Eldridge of the Oklahoma-based Love Without Boundaries Foundation, which oversees several programs to aid Chinese orphans, says many children with birth defects — boys as well as girls — are abandoned, and they now comprise a majority of the orphan population.

“Some parents feel the child will bring bad luck to their family,” said Eldridge, who has traveled often to China. “And we’re seeing many poor families abandon children with medical needs in hopes they will get care.”

The Garretts, in their 30s and without children, signed up in December 2008 for the traditional program that might lead to adoption of a healthy infant. But facing a long wait, they later entered the Waiting Child program, which features special-needs children and can complete an adoption in less than one year.

The Garretts — he’s an aluminum plant worker, she’s an office manager — have decided they’re not ready to take a child with a severe or incurable medical problem, so they’re seeking one with a correctible condition.

“We have reviewed a couple of children,” Julie Garrett said. “It’s grueling to look at their faces and try to make a decision if you could care for them, and come to the realization you’re not the best fit to be able to care for them the best they should be.”

‘A really happy kid’

Bethany and Kevin Durkin, who live in the Westchester County suburbs of New York City, went through a similar decision process and are now parents of two girls adopted through the Waiting Child program.

Olivia, 7, had a weak, underused right arm when she was adopted in 2004, while Lucy, 5, had a cleft palate that was repaired through surgery soon after her adoption in November 2007.

“They ask what you’re comfortable with,” said Bethany Durkin. “I wasn’t with hepatitis B or heart surgery, but we were comfortable with cleft palate.”

Both girls undergo therapy regularly — Lucy for speech, Olivia to improve the mobility of her arm and right hand.

“She does cartwheels, jump-rope — people don’t even know she has an issue,” Durkin said of Olivia. “She just can’t open her hand by itself.”

As for Lucy, “she’s a total social butterfly,” her mother said. “A really happy kid.”

Preparing families

Agencies focusing on adoptions from China now find that a major part of their work is preparing families to take on special-needs cases.

“We don’t want a family to join this program just because it’s faster — that’s the wrong way to go,” said Snow Wu, president of Great Wall China Adoption.

“We want them because in every aspect they’re ready — we screen them very carefully, financially, emotionally, physically,” she said. “This is not for everyone.”

Wu’s agency, based in Austin, Texas, has placed roughly 8,000 children in U.S. homes since 1996. Special-needs adoptions now comprise about half its caseload.

“We’ve not heard a single family say they shouldn’t have done it,” Wu said. “If they decide not to do it, it’s before they bring the child home. Once they do that, none have complained.”

Eldridge, of Love Without Boundaries, said advance education is crucial to the success of special-needs adoption.

“Some families get cold feet when they get to China,” she said. “We receive one or two calls a month from parents who feel overwhelmed while they are on their adoption trip, but often, once they have someone to talk with, they realize they can continue.”

She cited calls from parents who hadn’t been fully aware of the speech and eating problems faced by children with cleft palates.

Since it began encouraging international adoptions in the 1990s, China has won praise for striving to provide accurate information about the children in its orphanages. But as more children with complex medical conditions are put up for adoption, experts say there’s often less certainty about their prognosis.

“A lot of people are having to make lifetime decisions based on less information,” said Dr. Jennifer Chambers, who counsels parents as director of an international adoption clinic in Birmingham, Ala.

“There is more risk being taken because there’s more unknowns,” she said. “I don’t see false information, but I see lack of information, and different medical systems from ours.”