Video of birth played during homebirth trial
HOMEBIRTH advocate and former midwife Lisa Barrett told a client she was "stupid" to undergo liver function blood tests and told her repeatedly that her babies "were just going to fall out", a court has heard.
The Supreme Court was also played a confronting video of the woman's twin labour on Tuesday, in which Barrett appears calm and unconcerned about the mother's blood loss or second twin's plummeting heart rate.
Barrett, 52, of Petwood in the Adelaide Hills, is standing trial in the Supreme Court charged with two counts of manslaughter over the advice she gave two mothers before and during their homebirths. Prosecutors allege her advice was "gross negligence". Barrett has pleaded not guilty to both counts.
The 47-minute video of mother Sarah Kerr's labour shows the first twin was born without complication, but Ms Kerr experienced blood loss before the second twin, Tully, was born.
The court had previously heard Tully's heart rate dropped to as low as 60 beats per minute during labour, below the 120 beats per minute of what is considered healthy.
It has also heard Barrett appeared "calm, composed and almost casual during her approach" during Ms Kerr's birth.
Ms Kerr told the court that during her labour Barrett had not been concerned about her continued blood loss and had told her Tully was "in my pelvis and there for me to push out".
But, during the video the court heard Barrett said "you can't push him out because he's not in your pelvis", about half an hour after delivering the first twin.
At one point Ms Kerr can be heard asking Barrett if she was okay, which she explained was "because (Barrett's) hands were shaking and she dropped the doppler".
But she said "Lisa didn't seem concerned so I tried not to be".
About 20 minutes after the birth of the first twin, Ms Kerr can be heard asking "do we need to go in (to hospital)". Barrett's response was indecipherable.
Ms Kerr, who hired Barrett for her twin homebirth in October 2011, also told the court Barrett had told her "very frequently" that her babies "were just going to fall out" prior to her birth.
She said she told Barrett she was having blood tests to check her liver function, amid fears she had cholestasis which could harm her unborn babies.
"(Barrett said) that I was stupid to keep doing bloods, that it was doing nothing but stressing me out, that I just needed to focus on diet, that this was my body's normal reaction to this pregnancy," she said.
Ms Kerr said she stopped having blood tests after that conversation because she "didn't know what she was going to do with that information anyway".
During another pre-birth conversation, she told Barrett she had fears one of her babies was dead.
She said Barrett told her she should "not compromise my live baby for the sake of seeing my dead baby".
The court heard Barrett then checked Ms Kerr and found heartbeats for both babies.
Ms Kerr said she asked Barrett prior to her birth about developing a "transfer plan or caesarean plan" for going to hospital if required, but Barrett again reassured her that "my babies are just going to fall out".
She has previously told the court she had opted for home births after an earlier traumatic vaginal hospital birth, but was not averse to a cesarean section.
"A caesarean wasn't something that scared me."
When asked if she would give birth in hospital, if it had been advised by Barrett, Ms Kerr replied "yes".
She said she had formed a view in the latter weeks of her pregnancy that should any complications arise, that she would transfer to hospital.
Opening the trial last week, prosecutor Sandi McDonald SC said Ms Kerr's son Tully Kavanagh and another unnamed baby had "died as a direct result of the manner in which they were born" at home and Barrett's "gross negligence" meant neither baby was alive today.
She said Barrett was charged with manslaughter "by criminal negligence" because she failed to properly advise either mother of the risks prior to birth and urgent need to transfer to hospital when further problems were encountered during their births.
"As these babies tried to struggle their way through birth and in the process started to die, the accused made no efforts to save them either by telling the mothers of the true dangers they were facing, or by advising the mothers of the need to get to hospital as a matter of urgency if there was any hope of the children surviving," Ms McDonald said.
The second unnamed baby died following a home birth in December 2012.
Scott Henchliffe SC, for Barrett, has told the court "every element of each of the offences is in dispute".
The trial, before Justice Ann Vanstone in the absence of a jury, continues.