In this article, I analyze changes in the Czechoslovak-Vietnamese labor exchange program between 1967 and 1989, specifically Czechoslovak state policies toward pregnant Vietnamese workers. In the program, the Czechoslovak state's commitment to being a welfare provider was confronted with its commitment to socialist internationalism. The policies toward pregnant Vietnamese workers constituted a part of the process through which the Czechoslovak state was redefining the limits of care it saw itself obligated to provide. The conflict between the two states over the appropriate treatment of pregnant Vietnamese workers was also an outgrowth of a more general feature of Czechoslovak state socialism: the tension between the pressure to increase (or at least maintain) productivity and the pressure to increase fertility. The gradual transformation of the program into a more decentralized and market exchange-like form shaped the nature of the conflict, the attempts to resolve it, and the limited efficacy of the solutions.