I gave birth in both Puerto Rico and New York. There were several striking differences. — Business Insider

RESOLVING THE LEDGER

I gave birth in both Puerto Rico and New York. There were several striking differences. — Business Insider | AIPROPX

I gave birth to one of my children in New York and the other in San Juan. Sophie-Claire Hoeller

I had a baby in New York and in Puerto Rico. Both experiences were different in many ways.

Wait times for doctor appointments in Puerto Rico were longer, likely due to physician shortages .

I had to buy my epidural and some supplies in advance, but my husband had more access to amenities.

When I moved from Brooklyn to Puerto Rico two years ago, with my husband and then-3-year-old son, we were firmly "one and done."

Life with a toddler in New York City was too hard; we spent weekends at chain-link fence-enclosed playgrounds that were either shadeless and sweltering in the summer or freezing and depressing in the winter, struggled to find affordable childcare , and didn't have the village it takes to raise a kid.

Moving to Puerto Rico changed our tune. The near-constant sunshine, excellent and affordable bilingual schools, easy access to beaches, and welcoming people who instantly became our community had us considering a second.

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

My first child, now 5, was born in Southampton, New York, in August 2021. From the moment I started looking for an OB-GYN in San Juan, my experience 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 an OB-GYN open to new patients, and my appointments took forever

After moving to Puerto Rico, our family grew. Sophie-Claire Hoeller

I kept hearing from friends and fellow parents from my son's school that they were taking entire mornings or afternoons off work for standard doctor appointments — multi-hour waits were that common.

I didn't believe it until I regularly found myself waiting three hours to see my obstetrician. In Southampton, I considered a 30-minute wait a bad day.

A potential reason is Puerto Rico's severe doctor shortage . Lower reimbursement rates and wages than on the mainland have contributed to a long-running physician exodus, with many doctors leaving for better pay and working conditions.

Those who remain can end up juggling a lot of patients and overscheduling themselves to keep up, leading to the long wait times I (and many others) experience.

On top of that, it took me quite some time and a lot of searching to find an OB-GYN who was taking new patients in the first place.

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

I had to make a few key purchases before giving birth in Puerto Rico. Sophie-Claire Hoeller

In Southampton, I just showed up to give birth — I didn't really have to think about pillows, epidurals, or diapers.

In San Juan, patients must purchase these items from the on-site pharmacy. Pillows were $8 a pop, so I brought my own from home. I also brought my own blankets instead of buying them.

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

I was offered a bedpan for another $15 but declined. Had I had a boy I wanted circumcised, I would've had to purchase a circumcision tray for $100.

I had to buy my epidural in advance — and getting it was a whole process

In Southampton, I didn't fill out any forms before arriving at the hospital, asked for the epidural once I got there, and received it with no fuss. As far as I remember, it was fully covered by our insurance.

In San Juan, I went through pre-admission, in which I filled out tons of paperwork a week before my due date.

Part of pre-admission included purchasing an epidural. Many fellow moms who had given birth at the same hospital warned me that it sometimes runs out of epidurals, and to make sure they know I want one (and boy, did I want one!) well in advance.

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

Once in labor, the anesthesiologist came to my bedside and gave me a presentation — including diagrams — explaining in great detail how the epidural works and asking for consent before administering it.

My husband was well-fed and got a full bed to sleep in for a small extra fee

In Puerto Rico, my husband and I were both able to get meals during the hospital stay. Sophie-Claire Hoeller

In Southampton, I received a private room with an ensuite bathroom without having asked for it — lucky for me, the maternity ward at the hospital there doesn't have any other kind.

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 while I received three full meals a day, my husband wasn't provided any food — he was begrudingly given a cup of coffee when asked. That said, on our last night at the hospital, we were provided a celebratory steak dinner for two, which was sweet.

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

Each room cost a different amount — the nicer ones weren't covered by insurance and had to be prepaid — and came with different amenities.

My husband's bed during our hospital stay in Puerto Rico could be folded up and tucked away during the day. Sophie-Claire Hoeller

The one we chose, for example, came with full meals for the patient's partner, and so my husband received a tray of food every time I did.

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

Ultimately, I had a positiv...