Based on ethnographic fieldwork in clinics and maternity wards in European maritime borderlands, this paper compares and contrasts two national case-studies, those of southern Italy and Overseas France, to assess the deep intersection between historical neglect towards national peripheries and the hardening of border regimes and infrastructures, which has led to the emergence of medical landscapes specific to these international borderlands. Whilst pertaining to distinct national histories of territorial incorporation and imperial expansion, I argue these landscapes are marked by colonial hauntings which pervade the delivery of sexual and reproductive care of both local and migrant patients. This intersection of neglect and securitisation overshadows local communities’ daily lives, entrenching inequalities at national level. At another scale of governance, it also reinforces moralising tropes of deservingness that are both gendered and racialised and directly impact the legal and reproductive destinies of migrant patients who transit through them.