The mother of a baby who died during a home birth was well aware of the risks it posed, but proceeded with it anyway, the South Australian Supreme Court has heard.
Former midwife Lisa Jane Barrett is on trial for two counts of manslaughter over the deaths of two babies during home births in October 2011 and December 2012.
Supreme Court Justice Ann Vanstone is presiding over the case without a jury.
The prosecution argued the babies would have survived if not for Ms Barrett's involvement.
"It's not a momentary lapse or mistake of judgement, in my submission, it was reckless behaviour in the extreme," prosecutor Sandi McDonald SC said.
"These women should never have gone into labour at home.
"[Ms Barrett] chose to ignore the opportunities to get these women to hospital so they could deliver their babies safely."
The claim was rejected by Ms Barrett's defence lawyer Scott Henchliffe SC, who told the court "the direct causes of their deaths were not acts of the accused or her omissions".
He said the mothers were involved in the home birth community and one of the mothers — Sarah Kerr — had decided to have a home birth after experiencing a traumatic hospital birth some years earlier.
"If she hadn't chosen Ms Barrett to assist with her antenatal, she knew many other midwives who would have done it," he said.
"She knew about those unexpected things that can go wrong … she understood that having twins put mothers and babies at higher risk."
He told the court it was "human nature" for people to rationalise and reconstruct what happened in a way that reflected more positively on them.
The court heard Ms Kerr told Ms Barrett she wanted a "hands-off approach" birth and did not want physical examinations.
"A responsible practitioner would bear those things in mind in determining how they gave advice … to try to minimise any further trauma or emotional upset," Mr Henchliffe said.
Defence also told the court Ms Barrett was operating as a birth advocate and not a midwife at the time of both deaths and, therefore, had not broken any existing laws at the time.
'I thought I was going to die'
In late March, the mother of one of the babies, Sarah Kerr, gave evidence about what happened to her son Tully, who died during an allegedly negligent home birth on October 9, 2011.
She described how Tully was delivered inside the car as she, her partner Matthew Kavanagh and Ms Barrett made their way to the hospital.
She told the court that Tully, along with the placenta, was delivered onto the car floor in front of the passenger seat.
She said Ms Barrett performed CPR on Tully until they drove into the emergency bay at the Women's and Children's Hospital, before a "crowd of people" took him away for treatment.
Ms Kerr told the court that when she saw how many machines were needed to keep Tully alive, she turned to Ms Barrett and said: "Look what I've done".
She said Ms Barrett responded: "If you think home birth did this, then no-one should be having a home birth".
Ms Kerr also told the court that Ms Barrett encouraged her to throw a 47-minute video recording of the twin birth in the bin and discouraged her from speaking to investigating police.
Ms Barrett was deregistered as a midwife in 2011.
The trial continues.
