Given that prospective parents are often willing to pay thousands, even tens of thousands, of dollars (which they believe to be legitimate fees) to adopt foreign "orphans," a number of individuals have begun, essentially to buy and sell "paper orphans" - children whose parents are actually alive and well - for profit. Contingency pay for a given adoption can be well above the average annual salary in many developing countries.

Adoption trafficking takes many forms. In some cases, outright kidnapping occurs; in others, parents are given the choice between paying astronomical hospital fees or relinquishing their newborns to traffickers. In still others, facilitators trick local parents into thinking their children are going abroad to attend school when in reality the kids are being taken to new homes, never to see their birth families again.