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Manslaughter trial begins after two deaths during homebirths

A South Australian homebirth advocate who manipulated a woman into giving birth to twins at home gave completely inadequate care leading to the death of one of the babies, a court has heard.

Lisa Barrett is on trial in the Supreme Court charged with two counts of manslaughter of two babies who died during homebirths in 2011 and 2012.

"The accused came to believe her own publicity about her ability to deliver any baby, regardless of risk factors, in a home environment," prosecutor Sandi McDonald SC told the court on Friday.

Ms McDonald said Barrett had befriended and eventually attended the homebirth of a woman pregnant with twins.

She said Barrett knew the woman had been "highly traumatised" after giving birth to her second child in hospital, and manipulated her into giving birth at home.

Barrett told the woman "just because you're having twins doesn't mean you need to birth in a hospital" and downplayed the risks involved with a twin homebirth.

The woman gave birth to a healthy first twin, a girl, but Barrett was "calm, composed and almost casual in her approach" as the heartbeat of the second twin decreased.

Ms McDonald said Barrett eventually went outside the house and smoked a cigarette while she called the hospital to say they would be coming.

The second twin - a boy - was born in the car as Barrett, the woman and her partner made their way to hospital.

The baby was not breathing and had no cardiac activity when they arrived, but adrenaline was administered and he eventually showed signs of cardiac output.

He was put on a ventilator and moved to the neo-natal intensive care unit, but died two days later. 

Ms McDonald said medical experts called as witnesses will tell the court Barrett's conduct "fell well short of what might be expected of a reasonably competent midwife".

They will say giving birth to twins at home is not only inappropriate, but also highly dangerous.

The trial continues before Justice Ann Vanstone in the absence of a jury.

- AAP

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