Achtung Baby

by Sara Zaske

  Children were almost always swarming over this park. On one of our early visits, some older kids had climbed onto the top of the dragon’s head, and one boy had gone to the edge of the dragon’s jaw and started dangling from it with both hands. It was a long drop to the sand below. “Achtung!” I called out to him. He didn’t even glance in my direction. I looked around wildly. Where were his parents? Aside from a few parents playing with toddlers in the sand, all the adults were hanging out on the edges of the park, sitting on benches and drinking coffee. No one seemed bothered by the dangling boy but me.

  By the time I looked back, he had dropped to the ground and run off. In the meantime, my own daughter was taking off toward the tunnel. Sophia crouched down, peered into the dim interior for a moment, then crawled through. I stood outside, wondering what I would do if she suddenly freaked out and started crying in the middle. I needn’t have worried because she popped out the other end and ran across a wooden bridge and slid down the short slide at the end.

  I did go with Sophia up the back of the dragon, though. Once at the top, she wouldn’t go down the slide or sit in the dragon’s mouth. It was too scary. However, after climbing down its back, she went up again, this time with her father—then she came down again. It was like she was working up her courage to face the rest of the dragon.

  Watching Sophia run around the Dragon Park, I felt a mixture of worry and pride—along with a twinge of jealousy. The playgrounds of my childhood had all followed the same formula: slide, swing, teeter-totter, sandbox. They were nothing like this. This was real fun.

  It also wasn’t immediately clear to me how this freewheeling, slightly dangerous playground fit into a society that requires you to have all your forms in order, insists you show up on time, and expects you to pack your own bags. But it makes an odd sort of sense when viewed as part of the value Germans place on responsibility. Each child at the playground was expected to judge for herself what she could or could not do. Parents did not run around after their children telling them this slide was too fast or that climbing structure was too high. The children learned to manage the risk on their own and prepared themselves for each new challenge, like Sophia was starting to do with the dragon.

  When Zac and I walked back to our apartment from Dragon Park that day with our tired and happy three-year-old between us, it seemed as if we almost belonged. We were less like foreign tourists and more like residents. Yet, I couldn’t ignore the feeling in my gut that told me everything would soon be out of “ordnung.” Actually, it was more of a nauseous feeling. I was pregnant.

  2

  Berlin Babies

  Berlin did make staying home with Sophia easier. We now had a huge number of playgrounds and play cafés especially designed for young children to visit, not to mention a host of museums and child-oriented activities. During the week, we had most of these places to ourselves. Aside from parents with small babies, there were no toddlers or other young children running about. They weren’t in the stores running errands with their parents either.

  It soon became clear that the vast majority of young children in our Berlin neighborhood were in child care during the day. I was living in a place where being a stay-at-home mother with a three-year-old daughter was an anomaly. In fact, across Germany, more than 92 percent of three-year-olds are in some form of early childhood education, according to the Organization for Economic Cooperation and Development (OECD).

  Our apartment building overlooked a green, triangular city park with a small playground at the center. On one side of the triangle was a restaurant and an ice cream place, and on the other side were two kitas or child-care centers. I could always tell when most parents picked up their children from kita, usually around three or four p.m., because the playground would suddenly be full, and a huge line would form outside of the ice cream shop.

  Despite the wide use of child care in Germany, or perhaps because of it, I still had a difficult time finding a child-care spot for Sophia. I had the all-important gutschein, but the two kitas across the street from us had no available space. I then tried every kita in our immediate neighborhood and was met with the same answer: “kein platz.” No place. They told me to call back in August.

  My timing was off. Berlin kitas normally only enroll once a year in late summer. Still, after nearly six months at home together, I was ready to work and I could also see the wisdom of Nadine’s advice: Sophia needed other children. With some help and persistence, we found a spot for Sophia at a bilingual kita in the Treptow district directly to the south of our neighborhood that was willing to enroll her a few months early.

  When I took Sophia for her first day at kita, we were greeted with chaos. More than a dozen small children were running around squealing. A pair of boys had opened a chest on the side of the room and were hurling objects behind them in an effort to find a particular toy. Children as young as two were climbing up and down the stairs to a high loft space built above us; one kid dropped a stuffed animal over the side to watch it fall.

  When Friedrich Fröbel first invented kindergarten in 1840, he envisioned early childhood education as taking place in a type of Eden where children would be nurtured like plants. He also felt strongly that play was the way that children learned best, but I doubt that Fröbel had imagined the pandemonium of play that I saw at my daughter’s kita.

  Kita is short for kindertagesstätte, or child-care center. It is a hybrid institution that often includes care for nursery-age children (ages zero to three), as well as children in what we in America would consider the preschool and kindergarten years. While kindergarten is an academic class in the United States, kitas and kindergartens in Germany are separated from schools by their physical location and their focus. At kita, academic learning is not as important as play.

  In fact, at Sophia’s new kita, it seemed like all the kids did was play—loudly and with wild abandon. I wasn’t the only American who felt that way. Nicole, a fellow American expat who lived on the west side of Berlin, described her daughter’s kita day to me this way: “I drop her off. She goes screaming and running around, takes a nap, and then goes screaming and running around again.”

  Sophia had been in child care in the United States since she was four months old. Before we left, she’d been going half days to a child-care center with several teachers watching over a group of eighteen toddlers. (It got loud there sometimes too, but I’d never seen it as wild as the German kitas she went to.)

  Located on the bottom floor of an apartment building, this kita was organized into three rooms: one for infants and toddlers, a middle room for three- and four-year-olds, and a small room for the older kids in their last year or two of kita before starting school. When the principal first showed us around, that room was empty. “The older kids go out on a field trip almost every day,” she explained.

  Sophia would be in the middle room, which was the largest, but with all the kids running around, the space seemed awfully small to me. In the midst of the mayhem, a young man came over to greet us. He crouched down to introduce himself to Sophia and shake her hand. She had never had a male teacher before, but within a few minutes, he had charmed her. In fact, he was a favorite of all the kids.

  I was asked to stay the first few days to help her settle in there, but Sophia was off and playing almost the instant we arrived. I sat in the corner of the room, and she barely noticed me. After a couple days, the teachers told me I didn’t need to stay anymore.

  In addition to the main room, the children also had a “garden” to play in, a small area in front of the building that was filled with sand and toys. I heard other parents say they didn’t like that the garden was so small, but the kita tried to make up for that fact by taking the kids out as often as possible. Sophia’s group didn’t make as many field trips as the older kids, but they often visited the playground or the woods in the massive 216-acre Treptower Park across the street. They had a yoga class once a week in a separate studio space. On one trip, they went to a spa to tr
y out the sauna.

  Although this kita was supposedly bilingual, only two other children understood English well. There was one native-English-speaking teacher, who rotated among the three rooms of different-age children, and Sophia’s main kita teacher spoke English as well, but it was less than perfect. After the first few days, he pulled me aside to ask why Sophia kept saying she needed “to go party,” then run from the room. Trying not to laugh, I found myself explaining the meaning of the word potty to the embarrassed young German.

  I was one of only two parents who picked up their child midday. I soon saw that this was unusual, but I didn’t think about it too much at the time. I was still sticking to the American idea that any child-care experience, even preschool, should be limited, that the ideal situation was for the child to be at home with me. The timing was sometimes difficult, especially as the long stroller walk through the park sometimes lulled Sophia into a nap that she woke up from minutes after getting home, but all in all, I felt tremendously lucky. Sophia loved playing at kita, and I loved the ability to have some time to write—and more frequently, as I got bigger, to take a nap.

  Where Midwives Rule

  Having Sophia at kita also helped me solve another pressing problem. I needed to find a midwife. In Germany, midwives, or “hebammen,” not doctors, are the primary caregivers during the birth process. They handle prenatal care and the delivery itself, whether in the hospital or at home, as well as postnatal care. Doctors usually only come into the picture when there are problems that require major medical intervention.

  After some research, I found a midwife, Anjet, who was willing to talk with me in English. (My German-language CD set was a little short on the subject of pregnancy.) The only problem was that her office was located in the Berlin district of Kreuzberg. Although close to our own district of Friedrichshain, Kreuzberg had once been on the other side of the Wall, so that meant there were no direct train connections. To get to Anjet’s office, I had to take a U-Bahn (the Berlin subway), then a tram, and then a second ancient U-Bahn that traveled on top of the historic redbrick Oberbaum Bridge over the Spree River into Kreuzberg.

  On the day of my first appointment, I dropped Sophia off at kita and headed out extra early. Kreuzberg is known for its good restaurants and large Turkish population. I planned to grab a quick lunch there: a two-euro falafel im brot. It was excellent but left me incredibly thirsty, and I drank a whole bottle of water in a few minutes.

  Still early for my appointment, I walked calmly down the street and looked for the address. I couldn’t find it. I crossed the street and looked again. I passed it three times before I realized the office was in the hinterhaus, the back portion of the building. It took me another few minutes to discover that the office was above a yoga studio and, like many buildings in Berlin, the only way up was the stairs. At this point I was late, and with all the walking and being pregnant, I now had to pee.

  Anjet waited patiently for me. (She was probably used to her patients having to use the restroom immediately on arrival.) She acknowledged my profuse apologies about my lateness with a slight nod of her head.

  “Still we must end at the same time,” she said. “I have another appointment coming.”

  “OK. Sorry,” I said and fumbled with my notes. I’d brought a list of questions I wanted to ask her.

  Anjet was a tall, smart, young German woman. Younger than me. This set me back a bit. Before I started my quest for a midwife, I’d decided I wasn’t going to have one who hadn’t had children herself. And I could tell what the answer was going to be before I even asked that slightly rude question: “Do you have kids?”

  “No,” she said. “Though I hope to someday.” Anjet then told me about her training—three years at a specialized school for midwives—and the many years she’d been in practice, as well as about all the services she provided.

  I swallowed, knowing I was being unreasonable. Of course, she was a professional. For Sophia’s birth in the United States, I had also hired a midwife, though in America this was considered an unusual decision. Doctors control most of the birth and labor process in the United States. At the time, I wasn’t thrilled with the hospital culture that treated birth like an illness. My midwife in the States had twenty years of experience and five kids herself, all of whom had been born at home. I had a lot of confidence in her, and she had given me great care.

  Yet despite my best efforts, Sophia had been born in the hospital—after thirty-two hours of labor I needed a little “go juice,” or pitocin, a drug that strengthens contractions. I have few complaints because Sophia arrived healthy and happy. (With my midwife advocating for me at the hospital, I’d also managed to avoid having a cesarean, which the doctor had initially suggested.) Yet the whole hospital birth experience had been infused with so much unnecessary stress and antagonism that I did not want to repeat it, especially at a hospital in a foreign country in a language I hadn’t mastered yet. So once again, I found myself trying to have a home birth, only this time with a German midwife.

  Since my first interview with Anjet was only fifteen minutes, I tried to tell her everything that had happened with Sophia’s birth, what I hoped for my second child, and how nervous I was about going to a German hospital all at once. I was speaking so fast Anjet had to ask me several times to repeat information. Her English was excellent, but I was testing the speed limit. I took a breath and slowed down.

  Finally, I came to my most important question: “So if I have to go to the hospital, will you come with me?”

  “If that happens, I won’t be able to deliver the baby. There will be another midwife in charge at the hospital,” Anjet said. She assured me that chances were good that I could have the baby at home, since second births were usually easier. She also told me that midwives in Germany were allowed to administer some drugs at home, including a drug like pitocin. I blinked at her. That little difference might have saved me a harrowing trip to the hospital the first time around. Still I wanted reassurance.

  “But you’ll come with me?” I insisted. “If nothing else works, you will go with me to the hospital?” I was a little terrified about going to a German hospital—even the word for it, krankenhaus, didn’t sound like any place I wanted to be. If the ausländerbehörde was like an American DMV on steroids, I shuddered to think what a German hospital might be like.

  “Yes, I will come,” Anjet said.

  I smiled and shook her hand. I had my midwife.

  My first visit to a German hospital came well before my son was born. I had to fill out some forms. In Berlin, pregnant women who intend to give birth at home or at an outside clinic register at an area hospital ahead of time in case they need to be admitted during the birth. This seemed an improvement to my experience in the United States, when I’d shown up in the emergency room only to be faced with a nurse wielding a clipboard full of insurance forms she wanted me to fill out while I labored through contractions.

  Anjet recommended a hospital in Kreuzberg with a good reputation. I liked the idea of registering in principle, but I went to that krankenhaus prepared to do battle. After my experiences at the various government offices, I came armed with my binder full of documents, a German dictionary, and a notebook filled with pretranslated sentences and questions.

  I needn’t have bothered. The krankenhaus was nothing like the ausländerbehörde. The hospital, a long, low building, sat on top of a green hill on the banks of the Spree River. The maternity ward looked like a typical doctor’s office with padded chairs and soothing pastel walls. After a short wait, I was met by a nurse who, upon hearing my terrible accent, quickly switched to English. She took me into an office with a round table and patiently explained each form I needed to fill out and sign. She gave me no lectures and made no snide comments about my birth plans.

  The only scary form I had to sign was one that said that if I was unable to respond, I agreed to let the doctors do what they thought was necessary to save my life and that of the baby. I filled out blanks, che
cked boxes, signed, initialed, and signed again. I walked out of the hospital twenty minutes later into the bright riverside park. People were picnicking on the hospital’s front lawn as leisure boats floated lazily down the river. This krankenhaus didn’t seem like such a bad place to have a baby, if I had to go to a hospital, that is.

  The American Disadvantage

  Giving birth, even in the hospital with the best of modern medicine at your side, is still a risky thing for women to do. Of course, it’s much less risky in developed countries, but the United States, which is supposed to have one of the best medical systems in the world, has terrible maternal and infant mortality rates in relation to its peers.

  In fact, by moving to Germany, I had increased the odds in favor of my own and my baby’s survival.

  According to the Centers for Disease Control and Prevention (CDC), the number of U.S. women who died from pregnancy-related causes was 15.9 per 100,000 live births in 2012. In Germany, it was six per 100,000 live births in 2015, according to the World Health Organization (WHO). Even women in Saudi Arabia and the former war-torn regions of Bosnia and Herzegovina have a better chance of surviving pregnancy than American women. The U.S. numbers are pretty bad, but perhaps even more distressing, the maternal mortality rates in the United States have been getting worse, not better, even while rates in the rest of the world have been improving.

  The story for babies is similar. Nearly six infants out of every 1,000 American infants die before they are a year old. In Germany, the infant mortality rate is almost half that: at 3.4 per 1,000 births. Why the disparity? Scientists at the National Bureau of Economic Research (NBER) asked exactly this question in a study titled “Why is infant mortality higher in the U.S. than in Europe?” They compared the U.S. statistics to Finland, which has one of the lowest infant mortality rates in the world at less than three per 1,000 births, and Austria, which has a rate close to the European average (and near Germany’s rate).