Childcare in the peninsula is hugely expensive even when it is available. 150 person waitlists for 50 kid facilities are the norm. A dirty daycare will run 2k per month, and a nanny around 3k. I'm not sure what the situation is elsewhere but I have to imagine it is better. Home daycares aren't available because no one can afford a home. The crazy prices lead to shortages of services because none of the people who would provide them can live there.

Childcare is substantially more expensive and the public schools are not very good. You almost have to put your child in private school, and you are looking at $20k-$30k/year/child. The city is not very kid friendly in general.

And any surrounding districts with good public schools will of course have ever higher real estate costs.

Consider daycare which ranges between $1500 to $2000 per month in SF. Nannies are $2000 to $3000 per month.