An obstetrician believes two midwives who assisted with the home birth of a Melbourne mother, who died hours after welcoming her daughter, made an error of judgment in their care of her.
Gaye Demanuele and Melody Bourne were with 36-year-old Caroline Lovell when she delivered her second child in a birthing pool in her home in 2012.
They're now charged with her manslaughter, allegedly a result of gross negligence in their care of her.
Ms Lovell fainted after getting out of the birthing pool and after hyperventilating she later collapsed and went into cardiac arrest on January 23, 2012.
She was rushed to hospital but died early the following morning as a result of multi-organ failure.
Obstetrician John Campbell says he's a supporter of midwife-led home births and believes they're perfectly safe, provided a woman doesn't suffer complications.
But he believes the decision by Demanuele and Bourne to allow Ms Lovell to remain in the birthing pool for an hour after the birth was an error of judgment.
The decision meant they had to rely on estimates based on blood in the water, and Dr Campbell said he wasn't aware of any method of being able to measure that accurately.
"It's an unsafe practice in my opinion," he told a committal hearing in Melbourne Magistrates Court on Wednesday.
He believed Ms Lovell was bleeding consistently and steadily for the whole hour she was in the birthing pool and that she had lost more than the 400ml estimated by the midwives.
Ms Lovell collapsed shortly after getting out, which he said was consistent with blood loss. So too were her low blood pressure and two episodes of hyperventilating, he said.
Midwives believed the hyperventilating was the result of an anxiety or panic attack.
"I consider this to have been an error of judgment," he said.
Dr Campbell said the symptoms combined would've been enough for a sensible midwife to have thought of a "more important medical cause" than anxiety, such as blood loss.
Defence lawyers for the women have suggested a pulmonary embolism or amniotic fluid embolism might have been the cause of Ms Lovell's demise, noting both were raised by paramedics and emergency doctors who treated her.
Dr Campbell said that was a correct assumption on their part, given what they'd been told by the midwives about Ms Lovell having had minimal blood loss.
"They were presented with a collapsed woman and the evidence from midwives was there hadn't been any bleeding so the mind has to turn to other diagnoses," he said, adding he would have done the same if it was his patient.
"I can understand how this diagnosis was brought about, but looking at the clinical presentation I do not believe this is what has happened."
The hearing is continuing.
Australian Associated Press