A "birthkeeper" says she was not obligated to call an ambulance for a wellness influencer whose health fatally deteriorated after a free birth at home.
Doula Emily Lal was supporting Stacey Warnecke, 30, when she gave birth to her firstborn son Axel at a Melbourne home on September 29.
The new mum's health suddenly deteriorated shortly after the birth.
She was rushed to Frankston Hospital, where she suffered multiple cardiac arrests and died due to blood loss from a postpartum haemorrhage.
Ms Lal previously refused to engage with the investigation on the grounds she could incriminate herself, but gave evidence before the Victorian Coroners Court on Tuesday after being granted immunity from prosecution.
The unregistered doula was present with Ms Warnecke's husband Nathan during the birth, recounting how the beaming new mum quickly deteriorated after birth, becoming hot, pale and struggling to breathe.
In court, she defended not calling an ambulance, instead putting that decision on the struggling mum three times before a call was made.
"I don't think I have that obligation. It’s up to family. It's not up to me to make that decision for her," she said.
"That is the reason why women choose free birth. They value autonomy above other things."
Ms Warnecke had experienced a significant internal haemorrhage during childbirth, with her husband estimating she lost one to 1.5 litres of blood after the placenta came out.
Ms Lal said she would not give advice on whether she thought it was significant blood loss even if she was the only one in the room with birthing experience.
"I don't know what's too much. I'm not clinically trained. It's not my role to assess blood loss," she said.
The court heard Lal went back to the home after learning Ms Warnecke had died to thoroughly clean up before police arrived the next day.
She denied she did so because she was concerned about the consequences for herself after Ms Warnecke’s death.
“That’s really unfair. His wife has just died. The last thing he wants to see is the mess that’s left,” she said.
On Monday, Ms Lal was asked in hindsight if she would've done anything differently.
"If I was presented with the same situation again, I honestly don't think I would because it's not for me to try to convince a woman to go to hospital if that's not what she wants," she said.
The doula denied women who bought her services relied on her knowledge, saying she bore no responsibility because she was not an expert.
"I'm not telling anyone to listen to me," she said.
"It’s filling a void. A lot of women want a woman there to support them. They don't have a big sister or a family support."
Expectant mothers paid her thousands of dollars for her freebirthing packages, including Ms Warnecke who spent $6000 for Ms Lal to be "a friend".
Counsel assisting Rachel Ellyard asked the doula what the package got the expectant mum.
"My time, and that time was driving there and back, spending that time there and then ... cooking, cleaning and walking the dog," Ms Lal said.
She told the court she attended about four free births a month.
A free birth, unlike a home birth where a registered midwife is present, is done intentionally without any medical professionals.
Ms Lal, who operated her "Authentic Birthkeeper" business for five years, said she "didn't want to do it anymore" in October after Ms Warnecke's death.
"It was really traumatic watching someone that you love die. It was horrible," she said.
"I didn't think I would be able to be in a birth space without bringing her in there with me."
