In French Guiana, perinatal care remains a top priority in the second regional health program for 2018–2022. The challenge for this territory is to address the needs of three distinct regions with varying requirements. The Cayenne and coastal region has adequate infrastructure but is facing a significant influx of immigrants; the isolated inland area, including the Oyapock River, has few human resources and limited healthcare infrastructure; the western region and the Maroni River area are experiencing a population explosion, coupled with an inadequate healthcare supply. Despite the challenges faced in the territory, French Guiana has a network of highly committed professionals and is working to implement the necessary adaptations to address these constraints.