Studies across many countries and continents were also to show that parting with a child for adoption involves feelings of loss, grief, anger and guilt which for many birth parents cannot be wished away. The stressful nature of the event often gives rise also to physical and mental illness. Many of these birth mothers came to feel responsible for giving away their child, even if at the time they had almost no other choice. As a result they saw themselves as ``unworthy'' and had a very low opinion of themselves and a poor self-image. For some their sense of loss, far from diminishing with time, seemed to intensify and was particularly high at certain of the child 's milestones such as birthdays or starting school. (See Winkler & Keppel 1984; Bouchier, Lambert and Triseliotis 1991; Howe, Sawbridge and Hinings, 1992; and Hughes and Logan 1993; Wells, 1993). A summary of various studies on the subject concluded that:

``birth parents experience profound and protracted grief reactions, depression and an enduring pre-occupation with a worry about the welfare of the child''.

(Brodzinsky, 1990 p. 304).

Many of the mothers interviewed by the above studies wanted to establish contact with their sons or daughters from whom they had parted many years ago and viewed this as the only sway forward that would bring them some peace.