Lawyer argues against curbs on home births

Greater regulation of home births would force women determined to avoid a hospital birth to go "underground", increasing the risks for mother and child, an inquest has heard.

South Australian Deputy Coroner Anthony Schapel has been investigating the deaths of two baby girls in home births in 2007 and 2009.

Mr Schapel is also considering wider implications, including the regulation of private midwives and whether or not home births are desirable.

Babies Tate Spencer-Koch and Jahli Jean Hobbs were both unresponsive when they were delivered and died despite resuscitation efforts.

The same private midwife, Lisa Barrett, attended both births.

The inquest was told that she was also involved in another fatal delivery in Perth as a birth advocate and not a midwife.

In final submissions on Friday, counsel for Ms Barrett, Mark Twiggs said mothers who chose to have a home birth should not be considered uneducated or naive.

He said such women had considered the risks and were determined to avoid delivering in hospital.

"They have studied and made a choice, and they should always have that free choice," he said.

Mr Twiggs said more regulation surrounding home births would take away that choice.

"They need help, but heavy regulation is going to push these people underground," he said.

Counsel assisting the coroner, Naomi Kereru, said both births under investigation were considered high risk and highlighted the inadequacies of a lone midwife assisting a high-risk delivery at home.

She said expert evidence to the inquiry made it clear that Tate's death could have been avoided if she had been born in hospital.

Evidence also showed Jahli was a perfectly formed baby with a normal heartbeat just before birth, but a lack of constant monitoring of the girl's heartbeat meant issues that arose went undetected.

Jahli was delivered in the breech position, a risk factor medical authorities have identified as ruling against a home birth.

Tate was a large baby whose shoulders became stuck as her mother tried to push her out.

Ms Kereru said she was concerned about the advice Ms Barrett was giving to women who came to her wanting a home birth.

She said she was also concerned that the Ms Barrett, who no longer practiced as a midwife but called herself a birth advocate, had changed her title to continue her work and avoid sanction under new federal government regulations.

Mr Twiggs said both mothers had made their own decisions to have home births and there was no evidence that either had been influenced by anything Ms Barrett said.

The coroner will hand down his findings on a date to be fixed.