My husband, a physician, used to go to a little island called St Vincent, in
the Grenadines to teach at their medical school and work in their hospital for
two weeks every year.  (I went to the ceremony when their hospital was
declared Baby Friendly.)
I visited two of the rural healthy clinics to talk to bf moms.  Afterwards I
chatted with the head nurse at the clinic and asked her about childbirth
practices.  She said first time moms and multiple births were encouraged to go
to the hospital but often only made it to the clinic.  Subsequent births were
at home with grandma or a neighbor attending.
However the HCPs wanted the moms to be checked, so they told the pregnant moms
to not let anyone cut the cord except a HCP.  They were told to wrap the baby
and the attached placenta and come into the clinic so that the cord could be
cut.  The HCPs used this visit to examine the baby and the mother.  Keep in
mind that many of these woman would have to take a jitney bus or walk miles to
the clinic with a newborn.
Cynthia D. Payne
LLL of Berkshire County Massachusetts