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Childbirth on Europe’s Ultra-Periphery: Maternity Care, French Universalism and Equivocal Identities on the Maroni River, French Guiana

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Abstract

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.

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Notes

  1. 1.

    Institut de Formation en Soins Infirmiers.

  2. 2.

    Non-related Others are distant affines with whom traditionally social relations would have been avoided.

  3. 3.

    It is worth noting that French and EU nationals resident or visiting French Guiana are entitled to exactly the same healthcare coverage as in the rest of France; nevertheless French Guiana, as an Overseas Department, presents some peculiarities typical of remote European peripheries and borderlands such as worse health and economic indicators (ARS-Guyane 2011; Grenier 2011; Jolivet et al. 2009; PAHO/WHO 2012)

  4. 4.

    Official figures demonstrate high natality rates in St. Laurent du Maroni: in 2009, with 2300 births for a population of 20,000, it placed the birth rates of this small Guyanese town at over 100 births/1000 inhabitants (Jolivet et al. 2009: 80).

  5. 5.

    Maternity wards in France are classified according to the level of care they can offer. Level 1 maternity wards (maternité de niveau 1) offer standard obstetric care for pregnancies which are deemed ‘low risk’. They are staffed by midwifes, obstetricians and pediatricians. Level 2 maternity wards offer standard obstetric care, as well as a neonatal services. Level 3 maternity wards offer standard obstetric and neonatal care, but also have a neonatal intensive care unit. The maternity ward of the Andrée Rosemon Hospital in Cayenne is level 3, whereas the maternity ward of the Centre Hospitalier de l’Ouest Guyanais in St. Laurent is level 2.

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Acknowledgments

I would like to thank all research participants who welcomed me, kindly agreed to spend time with me, and respond to my questions. I could not have conducted this research without the generous support of the following funding bodies: the Gates Cambridge Trust, the UK ESRC, Trinity College (Cambridge), the Ville de Paris, the British Academy, the Wellcome Trust and the John Fell Fund. Finally, I would like to extend my thanks to Marc Brightman and Charlotte Weisberg, who generously agreed to share their work and discuss this chapter with me; a warm thank you to the editors of the present volume for their comments on earlier drafts.

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Grotti, V. (2017). Childbirth on Europe’s Ultra-Periphery: Maternity Care, French Universalism and Equivocal Identities on the Maroni River, French Guiana. In: Decimo, F., Gribaldo, A. (eds) Boundaries within: Nation, Kinship and Identity among Migrants and Minorities. IMISCOE Research Series. Springer, Cham. https://doi.org/10.1007/978-3-319-53331-5_5

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