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Obstructed Labour analyzes how the movement to legalize midwifery in Ontario reproduced racial inequality by excluding from practice hundreds of professional midwives from the global south. Global macroprocesses of power, institutional forms of exclusion, and interpersonal expressions of racism all play a part. Sheryl Nestel shows that unequal relations between women underlie the successful challenge to patriarchal medical authority mounted by provincial midwifery activists. This is a disquieting but fascinating counter-history of the re-emergence of midwifery.