Adoption in the US is regulated by each state. Women who choose to surrender their baby to be adopted can go through agencies or through private adoptions. There can be interstate adoptions and international adoptions - the rules vary depending on the state.

Even private adoptions have to have an agency involved to make sure it's a proper environment for a child, but the agency doesn't match the pregnant woman and the family. In private adoptions, generally, the family advertises or goes through an attorney to find a woman who wants them to raise her biological child. There is generally a lot of choice available for the pregnant woman to interview and choose an adoptive family.

There are fees involved, whether it's private or through an agency. In private adoptions, the law does not allow for any money to go to the pregnant woman except to cover living expenses and medical costs. "Buying" a baby is against the law.