Chinese President Xi Jinping and US President Barack Obama met last week to bolster relations between the world's two leading economies. But there's one area that doesn't seem to need much work. Adopting a child from the world's most populous nation.

Despite being on the other side of the world, China is still the No 1 overseas source for US families to adopt a child. And by far. According to the latest figures from the US State Department's Office of Children's Issues, of the 8,688 children Americans adopted from overseas in 2012, 2,697 were from China, a ratio of roughly 1-out-of-3, which has been true for the last 14 years.

The next closest country in 2012 was Ethiopia with 1,568 children, followed by Russia, 748, Republic of Korea, 627, and the Ukraine, 395

Erin and Scott Askins of Baltimore, Maryland, adopted an 11-month-old girl from China in 2005, and a 2 1/2-year-old boy in 2010. One day recently Erin was filling out forms at the doctor's office when she came to the section asking about the births of her children. Under "number of hours in labor and delivery", she almost wrote: 15 months for the first child, 3 1/2 years for the second.

"Then under 'complications'," she said, "I wanted to list Chinese government holidays, home studies, dealings with Homeland Security, three sets of fingerprints, dossiers, 15 hours of parenting class times two, two weeks in a communist country and a 15-hour-long flight with a screaming 2 1/2-year-old."

Data from the State Department office also track the average number of days to complete an adoption. China, at 267 days, is at the mid- to lower-end of the scale, with Mexico, averaging 770, the longest, and Panama, at 53, the quickest). On the median fees, again China falls in the mid range at $15,600, with Ecuador, Kenya and Sri Lanka at the low end at $6,200, and at the high end South Africa, which sent seven children to the US for adoption in 2012 with median fees of $160,217 for each.

So if China is neither a bargain nor the least hassle, what makes it such an attractive source for adopting a child?

Laurie Gruhn of New York City chose China because she was adopting as a single mother in her mid 40s and could only find a few countries for which she qualified, and of those, there were a few she was more comfortable with than others.

"I had heard for years that China was closed to single parents," Gruhn said. "Then I read a novel about a woman who had adopted from China (And Baby Makes Two by Judy Sheehan) and it made a deep a connection with me and focused me." China had a quota for single parents, and when she was given a slot, she grabbed it.

Gruhn started the paperwork in February 2006. Six months later, it looked like it would be a year's wait for a healthy 1-year-old. By 2007, it looked like another year, or longer. By 2008, Gruhn was ready to pull out.

Then, two years to the day that she logged in, Gruhn was told of a 3-year-old "waiting" or a special-needs girl with badly crossed eyes and an extra thumb, but otherwise quite healthy. She had been in an orphanage for about 6 months.

"I felt very comfortable moving ahead and becoming a family with her," Gruhn said. "I travelled there in November 2008, and stayed in China for two weeks. We have been home more than 4 1/2 years now. The process was much less predictable than I anticipated in terms of time length. Other than that, it was a joy."

Angie and Brandon Waldeck of Dallas, Texas, didn't find their way into adoption by being unable to conceive a child of their own. "We felt there were so many children already in the world who just wanted a loving family," Angie said. "The whole time we had this notion that we were enriching the life of a child facing tough odds in life." Since adopting Meilin from Shanghai in January, she said they have come to realize "that we are the ones whose lives had been enriched and forever changed."

Waldeck said the adoption process itself was "expensive, time-consuming, and not for the faint of heart". They found the paperwork and politics "staggering", from both the US and Chinese sides, not to mention "the fingerprints, essays, references, home study, prerequisite training, and mandatory reading".

The adoption training had warned them that MeiLin's transition from the orphanage might be traumatic, but they saw no signs of problems from day one. "She has such a happy disposition and her resilience is astounding," Waldeck said. "Each day we are amazed at how quickly she is adapting to our culture and language."

Clarissa South Holland of Madison, New Jersey, adopted a daughter from China in 1996. She said they picked China for several reasons. They already had a 2 1/2-year-old daughter and had decided not to have another biological child, since there were children in the world who needed parents. They knew they wanted a sister for their daughter. At the time, there was much in the news about the troubling conditions of orphanages in China. They also learned that China's placement offices preferred older couples, at least 30 years old but not of a combined age of more than 100. Clarissa was 38 at the time and her husband was 46.

"Our daughters are now 19 and 17 they are terrific human beings," Holland said. "We are grateful that China gave us the opportunity to adopt Rachel."