This chapter addresses the categories of social identities that are created and nurtured between medical staff and local women patients in and around the maternity ward of the hospital of St. Laurent du Maroni in French Guiana. This hospital is located in one of Europe’s most remote border regions, the Maroni river in South America, a large Amazonian river which marks the boundary between Suriname and French Guiana, and constitutes an international border between an emerging, postcolonial nation, and one of the European Union’s nine Ultra-Peripheral Regions. I will argue that childbirth on this periphery has turned into a place in which the delivery of care becomes embroiled in questions of migration, bureaucracy and French universalism, and that the peripheral nature of French Guiana exacerbates tensions surrounding national identity. St. Laurent’s hospital maternity ward is the largest per inhabitant in the whole of France yet most women who come to give birth do not speak French, nor do they possess either identity papers or entitlements to social security. Set against a backdrop of rising migration, these perspectives are affected by differing perceptions on the part of medical staff of notions of risk and control in which bodily health and national sovereignty are often intimately intertwined.