Comparing Birth Experiences: New York vs. Puerto Rico

Exploring the differences in childbirth experiences between Puerto Rico and New York, from healthcare access to costs and available services.

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 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 child.

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 of being pregnant and giving birth in New York and Puerto Rico was strikingly different.

One key contrast was the waiting times for doctor appointments. Friends from my son’s school often took entire mornings or afternoons off work for standard check-ups; multi-hour waits were that common. I found myself waiting three hours to see my obstetrician. In Southampton, I considered a 30-minute wait a bad day. A reason for these long waits is Puerto Rico’s severe doctor shortage. Lower reimbursement rates and wages have led to a long-running physician exodus, with many doctors leaving for better pay and working conditions.

Finding an OB-GYN who was accepting new patients took considerable time and effort. In Southampton, I simply showed up to give birth without needing to think about pillows, epidurals, or diapers. In San Juan, patients must purchase such items from the on-site pharmacy. Pillows were $8 each, so I brought my own from home along with my own blankets.

I also had to buy a mandatory baby care kit, which included items like a T-shirt, swaddle blanket, and diapers, and a delivery kit (which included a hairnet and scrubs for my husband) for $35 and $25, respectively. I declined the bedpan offered for another $15. If I had wanted my son circumcised, I would have had to purchase a $100 circumcision tray.

In Southampton, the process was straightforward. I asked for an epidural once I arrived, and it was fully covered by insurance. In contrast, in San Juan, I went through pre-admission, which involved filling out paperwork a week before my due date, including purchasing an epidural ahead of time. Fellow moms had warned me that they sometimes ran out of epidurals, so I made sure to emphasize my request. I ended up paying $1,000 for the epidural and went through an appointment with the anesthesia provider group, presenting my invoice and answering multiple medical history questions.

Once I was in labor, the anesthesiologist presented a detailed explanation of how the epidural worked, complete with diagrams.

After my Southampton experience, I expected another straightforward stay. I received a private room with an ensuite bathroom without needing to ask. My husband slept in a chair and still complains about how uncomfortable it was. I was fed three full meals a day, though he received no food from the hospital — just a cup of coffee when requested. Surprisingly, on our last night, we were provided a celebratory steak dinner for two, which was a nice touch.

In San Juan, however, each room cost differently, and amenities varied. We chose a room that included meals for my husband, meaning he received a tray of food whenever I did. It was spacious enough for him to sleep on a full bed, which cost an additional $10 per night but could be tucked away when not in use.

Giving birth in separate parts of the United States proved to be an interesting experience, highlighting how every hospital and birth experience varies, even in the same city. Despite some long waits and unique quirks, I had a smooth pregnancy and delivery in Puerto Rico, and I harbor no complaints.