I know this is sort of vague, but the details seem esoteric enough to potentially be findable, and I'm having no luck finding it myself. This was either from a piece of fiction, or from an autobiographical (humor?) piece written for entertainment (like Jean Kerr's Please Don't Eat the Daisies) and was from a female character's point of view. I think they were commenting on how many resources were devoted to the birthing process in the United States in modern times compared to other countries and times, with them making a comment about native or peasant women "giving birth in the fields", "extracting the afterbirth with their big toe", and then immediately going back to work. For some reason, the detail of using the big toe has stuck with me through all of these years, presumably because of how ridiculous it seems to use that part of anatomy (I'm still not certain how one would even do that).
I probably read this in the mid 1980s to the mid 1990s, in English, while living in Kentucky, but the source may be much older.