ARI SHAPIRO, HOST:
New parents stress about a lot of things. One of the most common worries is about who will take care of their baby when they go back to work.
AUDIE CORNISH, HOST:
NPR, along with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, surveyed more than a thousand parents nationwide. One-third of them reported difficulty finding child care. NPR's Jessica Deahl wanted to unpack this problem, so she started out where most parents do - on a tour of a child care center.
TULLI NORRIS: Hi, good afternoon. I'm Tulli. I am the business manager here at Bright Horizons at Georgetown.
JESSICA DEAHL, BYLINE: Tulli Norris has a very important role at this child care center in Washington, D.C. She fields new applicants and mans a very long waitlist.
NORRIS: OK, we're going to start this way.
DEAHL: It's easy to see why this center appeals. It's clean and orderly. Big windows let the sunshine in, and you see a lot of teachers down on the ground playing with happy babies.
UNIDENTIFIED WOMAN: (Singing) Where is Quincy? Where is Quincy? There she is.
DEAHL: At any given time, this center could have 50 families waiting for an infant slot. I ask Tulli Norris if she ever encounters desperate families who she wants to help but can't.
NORRIS: It happens, like, all the time virtually. A lot of times what will actually happen is someone will call me very upset and crying that they have to go back to work in a month and what are they going to do? And I'll get off the phone and then I'll go cry to my director. What are we going to do? How are we going to help them? And all I want to do is be able to get them in, but I have to make sure I'm following a process that's fair for everyone. But yes, that happens all the time.
DEAHL: Megan Carpenter of Alexandria, Va., knows that feeling of desperation. She had a hard deadline. Sixteen weeks after her baby was born, her maternity leave would end, and she'd have to return to her job at a nonprofit, so she and her husband started looking for child care early, only a few months into her pregnancy.
MEGAN CARPENTER: You know, our first few interviews, we were asking a lot of questions and were really trying to get a feel for the place. And by place number 10 and 11, our only question was, do you have a spot?
DEAHL: The answer to that question time and again was no, so that meant getting on waitlists - a lot of them - and paying a hefty nonrefundable waitlist fee for each one.
CARPENTER: There were a lot of places that were totally willing to take our hundred-dollar or $200 waitlist fee. We spent over a thousand dollars in waitlists fees and many of which I never heard from again.
DEAHL: Ultimately, Megan and her husband convinced their mothers to take time off their jobs and fly out from Georgia and Missouri to watch the baby in shifts until a center spot opened up. Scenarios like this play out over and over around the country. An analysis of some 7,000 ZIP codes by the Center for American Progress describes roughly half as child care deserts. While Megan Carpenter's experience is representative of what many working parents go through, Narinder Walia's is a worst-case scenario. She lives in Fremont, Calif., and works in biotech. Her baby boy, Avin, was born on Halloween day 2014.
NARINDER WALIA: I was supposed to be going back to work after four months, but what I did not realize is it was not very easy to find child care. I made almost 70-some phone calls, and not many panned through.
DEAHL: If you're not sure you caught that number right, I'll repeat it. She says she called some 70 centers. Three of them were willing to take her baby. Of those, she says, two were messy and disorganized. The third option, an in-home facility, was the best available. It catered to toddlers and older children, but the owner assured her they could handle a baby. What happened on Avin's first day at this in-home facility is hard to hear.
WALIA: I was on the way to go pick him up, and the Kaiser ER called me. And they kind of said, you have to come over. Your son is here.
DEAHL: To settle Avin for his very first nap on her watch, the caregiver placed him belly-down in his bassinet. And while she told Fremont police that she turned him over after 15 minutes, the act of putting him stomach-down goes against established infant care guidelines set by the American Academy of Pediatrics, the thinking being it places babies at much higher risk for sudden infant death syndrome.
Shortly after Avin was placed belly-down in his bassinet, he stopped breathing. On his first day away from his mother, he died. He was 3 months old. The coroner's report confirmed SIDS as the cause of death.
WALIA: I couldn't wrap my head around it because he was totally fine. He was smiling. He was a big baby, all chubby. There was nothing wrong with him.
DEAHL: What happened to Narinder Walia's family is rare, but it happens, and it is the deepest fear of parents who face severely limited child care choices. So this leaves us with a question. Why does the supply of quality licensed infant care not meet the very great demand for it?
The answer's complicated, but here's the central rub. This is an extremely low-profit industry. Costs are high. There's real estate, supplies, insurance and, above all, labor. A lot of states require something like one caregiver to every three or four babies. And centers can't really raise their prices. What parents pay already rivals college tuition. So low profits and high liability make for an uninviting business climate. But some are making it work.
DAVE LISSY: Over the past 30 years, Bright Horizons has grown to operate over a thousand locations now in 42 U.S. states in addition to the District of Columbia.
DEAHL: That's Bright Horizon CEO Dave Lissy. That center we went to earlier - it's one of those thousand-plus locations. Bright Horizons has grown and been profitable. So what's their secret?
LISSY: We've convinced employers to invest over a billion dollars in either capital investments or subsidies for their working families. That just didn't exist before we pioneered the model.
DEAHL: A key word there - subsidies. Employers like Chevron, Home Depot, Starbucks have partnered with Bright Horizons to build child care centers primarily for their employees. They cover most or all of the cost to build these centers. And...
LISSY: After that's all done, on average, tuitions are funded 75 percent by parents and about 25 percent through employer subsidies.
DEAHL: So parents pay their college-tuition-like sum, and employers pay even more on top of that. Bright Horizons is able to build these bright, cheerful centers because they're cushioned from their industry's harsh economic reality by generous employer underwriting. Without that cushion, the rest of the child care sector - the vast majority of it - is weak. And that creates a problem recognized by left- and right-leaning policy thinkers.
ANGELA RACHIDI: There definitely is an issue of child care supply, and there's lots of reasons that sort of feed into that. But I think it is an issue, you know, up and down the income scale.
DEAHL: That's Angela Rachidi of the conservative American Enterprise Institute. She says this is a challenge worthy of government attention and funding.
RACHIDI: Not only does that then benefit children, but it also helps the parents work.
DEAHL: Katie Hamm of the left-leaning Center for American Progress agrees. She says without much greater public support of the child care industry, demand for licensed infant care will continue to outpace supply.
KATIE HAMM: We've heard a lot about infrastructure in Washington, and it seems like there might be some consensus both with the incoming administration and among members of Congress that we need an infrastructure investment. And a lot of people talk about that and mean roads and bridges. But before parents can get on roads and bridges and support our economy, they need child care.
DEAHL: For Narinder Walia, more good quality infant care can't come soon enough. She's expecting another child any day.
WALIA: I'm kind of being very hesitant even thinking about a child care service right now. In my mind, I just want to hold on tight and not let them go, but obviously that's not practical.
DEAHL: Jessica Deahl, NPR News.