I gave birth in both Puerto Rico and New York. There were some notable differences.

When I moved from Brooklyn to Puerto Rico two years ago, together with my husband and then three-year-old son, we were resolutely ‘one and done’.

Life with a toddler in New York City was too hard; we spent weekends on fenced playgrounds that were either shadeless and sweltering in the summer or freezing and depressing in the winter, and we struggled to find affordable childcareand did not have the village necessary to raise a child.

Moving to Puerto Rico changed our tune. The near-constant sunshine, excellent and affordable bilingual schools, easy access to beaches and hospitable people who immediately became our community made us think about a second one.

Fast forward to April 2026, and we welcomed a baby girl in San Juan.

My first child, now 5, was born in August 2021 in Southampton, New York. From the moment I started looking for a gynecologist in San Juan, my experience of being pregnant and giving birth in New York and Puerto Rico was strikingly different.

Here are some of the biggest contrasts I noticed.

In Puerto Rico, I had a hard time finding a gynecologist who was open to new patients, and my appointments took forever

I kept hearing from friends and fellow parents at my son’s school about taking entire mornings or afternoons off work for routine doctor appointments – wait times of several hours were common. That Ordinary.

I only believed it when I regularly had to wait three hours before I could see my midwife. In Southampton I considered a 30 minute wait to be a bad day.

One possible reason is that of Puerto Rico serious doctor shortage. Lower compensation and wages than on the mainland have contributed to a long-term exodus of physicians, with many physicians leaving for better wages and working conditions.

Those who stay may end up having to juggle many patients and over-schedule themselves to keep up, leading to the long wait times I (and many others) experience.

Moreover, it cost me quite a bit of time and a lot of searching find a gynecologist who primarily accepted new patients.

Things I took for granted in New York had to be purchased from the hospital pharmacy in Puerto Rico

In Southampton I just turned up to give birth – I didn’t really have to think about pillows, epidurals or nappies.

In San Juan, patients must purchase these items at the local pharmacy. Pillows were $8 each so I brought my own pillows from home. I also brought my own blankets instead of buying them.

I ended up buying a mandatory one baby care set (which includes things like a T-shirt, swaddle blanket and diapers) and a delivery kit (which includes a hairnet and scrubs for my husband) for $35 and $25 respectively.

I was offered a bedpan for another $15 but declined. If I had a boy that I wanted circumcised, I would have had to buy a circumcision tray for $100.

I had to buy my epidural in advance – and getting it was quite a process

In Southampton I didn’t fill out any forms before arriving at the hospital. asked for the epidural When I got there I received it without any hassle. As far as I can remember, it was fully covered by our insurance.

In San Juan, I underwent pre-admission, which involved filling out tons of paperwork a week before my due date.

Part of the pre-admission was the purchase of an epidural. Many fellow moms who had given birth at the same hospital warned me that sometimes they ran out of epidurals, and to be sure I wanted one (and boy, did I want one!) well in advance.

So I bought an epidural from the billing department for $1,000. I then had to make an appointment with a member of the hospital’s anesthesia team, present them with the paid invoice, and answer dozens of questions related to my medical history.

Once labor had started, the anesthetist came to my bedside and gave me a presentation – including diagrams – explaining in detail how the epidural works and asking for permission before administering it.

My husband was well fed and given a double bed to sleep in for a small additional charge

In Southampton I was given a private room with a private bathroom without even asking for it. Luckily for me, the hospital’s maternity ward doesn’t have another room there.

My husband slept in a chair and complains about how uncomfortable it was to this day (I don’t remember there being enough room for another bed).

And even though I got three full meals a day, my husband didn’t get any food; he was reluctantly given a cup of coffee when asked. That said, on our last night in the hospital we were given a celebration steak dinner for two, which was sweet.

In San Juan, during pre-admission, I was given a list of several hospital rooms to choose from, ranging from shared rooms with limited visitor privileges to private suites with mini-fridges and extra space.

Each room cost a different amount (the nicer ones were not covered by insurance and had to be paid in advance) and had different amenities.

For example, the one we chose included full meals for the patient’s partner, so my husband got a tray of food every time I did.

It was also spacious enough to allow him to sleep on a double bed, which cost an extra $10 per night and could be folded and tucked away when not in use.

Ultimately, I had a positive experience with the birth in Puerto Rico

It was certainly interesting to give birth in separate parts of the United States, and my experience is solely my own. Every hospital and every birth experience is different, even if two people are having a baby in the same city.

Despite long wait times and some surprising quirks, my pregnancy care and delivery in Puerto Rico went smoothly, and I have no complaints.