Obstructed Labour: Race and Gender in the Re-Emergence of Midwifery. Sheryl Nestel. Vancouver: UBC Press, 2006; vii+200 pages; ISBN 0-7748-1220-6; $29.95 (paper). Mainstreaming Midwives: The Politics of Change. Robbie Davis-Floyd and Christine Barbara Johnson, eds. New York: Routledge, 2006; x+559 pages; ISBN 0-415-93151-7; $31.95US (paper).
Sheryl Nestel's Obstructed Labour is an examination of how the activism and rhetoric leading to the legalization of midwifery in Ontario reproduced racist discourses, problem atically affecting immigrant midwives of colour. Nestel posits that Third W orld women played significant roles in supporting the legalization of m idwifery, while sim ultaneously being used in juxtapostion to the movement's construction of "respectable" m idwives. She takes the reader through the local, institutional and interpersonal "technologies of exclusion" within the movement, as well as the larger global processes of domination that arise in the common practice of m idwifery tourism , where aspiring midwives travel to Third W orld countries in order to gather birthing experience. Nestel also highlights narratives from midwives of colour, detailing their experiences of both exclusion and resistance. She closes her work by insisting that "in order for there to be a glim mer of hope in constructing political projects that do not reproduce hierarchical relations am ong wom en" (166), it is vital to acknowledge and account for the errors of past political projects.
Nestel's work makes good on its advocacy of the painful accounting for errors of the past, weaving the reader deftly through a highly troubling depiction of racism and the propagation of hegemonic

discourses arising from a well-m eaning feminist endeavour. Obstructed Labour is neither an easy nor palatable read. However, as disheartening as some of the inform ation is, this work is highly im portant to the growth of feminist activism and scholarship, as well as for the growth of the m idwifery movement. I would highly recomm end this book to W om en's Studies classes and to feminist readers of all backgrounds. The theme and analysis transcends the midwifery movem ent itself, providing an excellent examination of the dangers of adhering to notions of generic womanhood and of all forms of socially conscious organizing which do not allow for dissenting voices.
It should be emphasized that this book is not an indictm ent of midwifery. W hile certainly critical of how the licensure of Ontario m idwifery cam e into being, Nestel never questions the importance of midwifery and the alternative birth movement. Instead, Obstructed Labour offers a difficult but necessary wake-up call to feminist theorists and organizers of all backgrounds.
Mainstreaming Midwives provides a variety of essays about the historical and current contexts of midwifery in the United States (US). The book is separated into three distinct sections, each outlining a particular theme within the US m idwifery movement. Section I analyzes the national context of midwifery, examining the development of nurse and direct entry m idwifery, as well as highlighting the tensions between the various national midwifery bodies. Section II provides case studies of the struggles and successes of direct-entry midwives to obtain licensure in seven states in the US. Section III examines som e of the core issues related to the project of mainstreaming midwives, including tensions between midwives who choose to practise outside of state regulated practices and those who are more protocol oriented, and the frictions that occur in the attempts to balance the project of professionalization against the social movement of m idwifery. Mainstreaming

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Midwives concludes by delving into many reasons why midwifery needs to be maintained as both a vital, growing profession and a social movement.
Mainstreaming Midwives veers from the theoretical in-depth nature of Obstructed Labour, providing the reader with a useful and highly descriptive overview of many of the issues facing midwives and alternative birth com m unities in the US today. The work is at its strongest when examining the im pacts of having a fractionalized m ovem ent, exploring the tensions between a need for m ovem ent unity while also maintaining space for differences in midwifery philosophy and practice. W hile this book does provide a useful overview of the American midwifery movement, there are also areas in Mainstreaming Midwives that are somewhat concerning. In general, there is a lack of attention to issues of diversity and several authors throughout the book make use of the term "woman" or "wom ankind" without problematizing these generalizing terms. To argue that midwifery benefits "wom ankind" does not allow for a thoughtful analysis of the varying degrees of m arginalization and privilege among groups of women, including women who practise as midwives and those who access (and do not access) midwifery services.
My biggest criticism of Mainstreaming Midwives (and this is a problem that occurs throughout the work) is that surprisingly little respect is offered for wom en who choose more traditional birth options. A few (of many) examples of this occur as one author makes an offensive reference to "counterfeit birth" (414), and the editors note in their conclusion that they "believe that midwives should become the prim ary caregivers for most Am erican wom en throughout pregnancy and birth" (508). W hile it seems clear that their positioning midwifery care as a superior birthing option comes from a place of genuine caring about women's birth experiences, this anthology tends to paint an overwhelm ingly singular picture about medical/hospital births, as well as to

denigrate the choices of wom en who choose not to use midwifery care for their birth experiences. This is both ironic and distressing, given the propensity of midwifery rhetoric to hold up women's "choices" as one of the most im portant elements to the midwifery model of care.
W hile overall I'd say that Mainstreaming Midwives is a generally informative read, I believe that the midwifery m ovem ent is better served by trying to argue for a greater range in birth choices for women, rather than attempting to make decisions on women's behalf.
Natasha Pinterics Mount Saint Vincent University