Are you relocating to the island in the middle of a pregnancy? Whether it’s for military orders, a new job, an Act 60 move, or simply a decision your family has made to live a slower life, you’re taking on two enormous transitions at once — and I believe families deserve better information than the general relocation guides will give you.

I’ve walked alongside a lot of families who have made this move. Here’s what I’d want you to know before you arrive.

The single most useful thing you can do is understand how your provider search interacts with your due date.

First trimester: You have time. Take this time to interview providers rather than settling for the first one who answers your call and has availability. This is the easiest version of this transition.

Second trimester: Still workable, though you’ll want to move quickly once you land. Your medical records will transfer, the 20 wk Fetal Anatomy Scan can be scheduled still, and some practices will still take you.

(Late Second Trimester) Third trimester: This is where families run into real trouble. Many practices here won’t accept transfers after a certain point in pregnancy — they want to have established care with you before a delivery and are often at capacity. If you’re arriving at twenty-eight weeks with no provider lined up, you may find your options genuinely limited.

If your move lands you here in the third trimester, don’t wait until you arrive to begin calling around; start the search before you arrive. 

Get physical copies of everything before you leave. Please don’t arrive planning to access a virtual patient portal or faxing records over later. 

You’ll want your prenatal labs, your ultrasound reports, your prenatal chart, and a summary of any complications or relevant history. Having your records trasnferred between the mainland U.S. and the island is unreliable in a way that surprises people, and arriving with your own file removes this additional burden.

I want to prepare you honestly, because the difference between expectation and reality is where most people find themselves caught off-guard.

Appointment wait times are long here.  At every visit. Four or five hours for a routine prenatal visit is normal in many areas. This is because the healthcare system is understaffed and limited compared to the demand. This type of disruption in your weekly schedule is important to know upfront. You’ll want to plan accordingly. Bring snacks, a book, and lots and lots of patience.

Hospital amenities vary enormously across the island. Private recovery rooms, meal quality, breastfeeding support, and nursery policies differ dramatically from one facility to the next. What you experienced elsewhere tells you very little about what you’ll find here.

The pace is different. Care here often moves more slowly–even with really great doctors. 

You’re leaving your support system behind…The friend who would have brought you dinner and watched your toddler. Your mother, who was going to stay for two weeks. The people who know you well enough to notice when you’re not okay. 

Postpartum in a new place, without that network, is genuinely hard — and it’s the part almost nobody plans for because it doesn’t feel like a logistics problem the way housing and insurance do. But it’s the one I’d most want you to think about before you arrive.

I recommend you start building connections during pregnancy. Find the parenting groups in your area. Say yes to an acai-date with a mom you barely know. Arrange your postpartum help before the baby comes, because arranging it afterward requires energy you won’t have.

– Call your insurance and confirm what thins are covered before you need it

– Identify your nearest hospital (that offers labor and delivery services) and drive there once, so you know the route and can get an idea about the parking situation

– Begin the provider search, even if you’re not ready to commit

– Find one local parenting group and introduce yourself

– Locate a pharmacy and a pediatrician, before the baby arrives

Families move here pregnant all the time and go on to have beautiful, well-supported births. What separates the smooth versions from the difficult ones isn’t luck — it’s how much they sorted out in advance.

The island has real gifts to offer a growing family. Slower rhythms, warmth in every sense, communities that fold you in once you find them. It’s worth the effort of arriving prepared.

If you’re in the middle of planning a move and trying to figure out what to handle first, that’s exactly the kind of thing I help families sort out. Reach out and we can build a plan around your due date and your timeline.