This chapter focuses on common law jurisdictions, and considers some of the early human rights challenges, and the shaping of modern principles, policy and practice. It explains current adoption types and trends and outlines current adoption law. The chapter examines each sequential stage of the adoption process, identifying and assessing the relevant human rights concerns. It concludes by reflecting on some of the most characteristic features of the interaction of human rights with adoption law and practice in the US. Adoption as a formal statutory procedure was introduced in the US by the Massachusetts Adoption of Children's Act 18511 which preceded the introduction of similar legislation in England and Wales by 70 years and set out for the first time some of the more basic functions of the law relating to adoption. The challenges involved in regulating domestic adoption practice probably first surfaced with the 'orphan train' programme.