No one has mentioned manual extraction of placenta. Although this can be very uncomfortable for a woman without analgesics, it can prevent large blood loss when indicated.
Ideally this should be done with a sterile gloves and gown, to minimize infection. I am successful 95% of the time by simply placing 2 fingers in the vagina and apply downward pressure on the placenta/membranes just above the cord insertion, while applying gentle and slightly upward traction to the cord. I curl my fingers slightly downward to get some "traction" on the membranes. This also allows me to feel if the placenta is descending and helps to guide the amount of traction. If a tearing sensation is felt (the cord separating) then traction on the cord is reduced.
If this is ineffective and the mother is bleeding heavily, then I will need to enter the uterine cavity with my hand, while applying fundal pressure for stabilization, and manually remove the placenta. Keep in mind, the cervix and vagina have just passed a baby's head which is much larger than a hand, so this is not as horrible as it might seem and can be life saving. I have only had to do this a few times in my career, as the above mentioned technique works well. That said too, this is not a procedure that is practiced and rehearsed in Med School, so a confident midwife should do just as well as a first time physician.
Would recommend reviewing the literature and diagrams before attempting though, and then only if bleeding is severe and help is not imminent.
Hope this helps.