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In Bulgaria, you send in commitment papers for a child on the SN list or when you receive your referral you accept that referral and that child is held for you while you complete your paperwork. There is no need to worry that your child won't be available when you get there. Benefits of Bulgaria being a Hague country.
Accuracy of the medical reports are a gamble. It helps if you have the files read by an international adoption dr and you have the option of not going forward with the adoption once you have met the child on trip 1. Our agency will allow fees paid to be transferred to a new adoption under some circumstances so we would be out no more than travel expenses for first trip.
Adoption is an act of faith! The children are worth it.
Our son is 6 and came home in Jan 2013. He's doing amazingly well. He was a SN WC but most of his delays seem to be just orphanage delays as he is catching up.