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The library historically only used the v1 REST API, which is why create_page() started failing on Confluence Cloud with that PermissionException. The maintainers implemented v2 API support in the 5.0.0 release, so the fix is to upgrade to 5.0.0 or newer. If you cannot upgrade, the workaround users verified is to bypass the library for page creation: create the page with a raw requests POST to https://your-domain/wiki/api/v2/pages using HTTPBasicAuth with your email and API token, then use the library's update methods with the returned page ID.
Source: https://github.com/atlassian-api/atlassian-python-api/issues/1200
Source: https://github.com/atlassian-api/atlassian-python-api/issues/1200