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Although fundamental to adoption, the experiences of birth families have received little attention in adoption research. When birth families are considered, it is mostly through the lens of how they influence adoptive parents or adoptees, resulting in a paucity of examinations where birth families are the center of scholarly focus. To address this gap in our understanding, we used a modified grounded theory approach to analyze 15 interviews and two focus group discussions with U.S. birth mothers (with additional interviews ongoing). Through this study, we explore individual choices and circumstances while situating them in broader contexts like trends of racial and economic inequality. While these two facets may seem competing—birth mothers as empowered to choose what is best for them and their children and birth mothers who are caught in larger trends of inequality—they may be interactive. Birth mothers are a vulnerable group who largely belong to marginalized sociodemographic populations. They face unique state involvement in which clear, documented, and final choices are made about them and their children. Further, they face intimate and direct entanglement with advantaged families. Therefore, examinations of birth mothers are uniquely situated as a window into broader societal family inequalities.