This article addresses birth parents in the adoption triad by reviewing and integrating both the clinical and empirical literature from a number of professional disciplines with practice case studies. This review includes literature on the decision to relinquish one's child for adoption, the early postrelinquishment period, and the effects throughout the lifespan on birth parents. Clinical symptoms for birth parents include unresolved grief, isolation, difficulty with future relationships, and trauma. Some recent research has found that some birth mothers who relinquish tend to fare comparably to those who do not relinquish on external criteria of well-being (e.g., high school graduation rates). However, there appear to be serious long-term psychological consequences of relinquishment. Limitations of the current literature are presented, and recommendations for practice and research are offered.