A 'birth keeper' who watched as a popular Melbourne nutritionist and food influencer struggled during childbirth said she had no obligation to call her an ambulance. 

Stacey Warnecke, 30, died in hospital on September 29 from complications of postpartum haemorrhage, several hours after giving birth to her son Axel at home without medical assistance.

On Tuesday, the Coroners Court of Victoria heard Ms Warnecke chose not to receive any healthcare during her pregnancy and gave birth at home alongside her husband Nathan and 'birth keeper' Emily Lal. 

Lal, a mother of four, had built a significant following among mothers before Ms Warnecke's death. 

She appeared at the coronial inquest, but only after being granted a certificate against self-incrimination. 

The court heard Lal had declined to speak to police ahead of the inquest, and that when officers attended the scene the following day the house had been 'extensively cleaned by Ms Lal'. 

Rachel Ellyard, counsel assisting Coroner Therese McCarthy, questioned Lal about how she operated while supporting mothers giving birth at home. 

Asked if she would call an ambulance if she had concerns about a mother's condition, Lal insisted the decision was up to the mother. 

'It would really depend on what the mother wanted. So if she wanted my support, then I would support her to the best of my ability,' she said. 

'I would call for an ambulance if that's what she wanted. And then just support her in any way that I could.'

'So you'd wait for her to ask for the ambulance?' Ms Ellyard asked. 

'I would ask if she would like an ambulance, but if she said "no", then that's the answer,' she said. 

Lal said she was being paid to be a 'big sister' to mothers, not to keep them safe during childbirth. 

'I'm not there to make a birth safer. I can't do that,' she said. 

Lal said she had 'no obligation' to intervene in a childbirth when complications presented.  

'I don't think I have that obligation,' she said. 'She's supported by her family. 

'There's always a husband or a partner present and I think it's up to the family to make that decision. It's not up to me to make that decision for them,' she said. 

The inquest heard clients paid Lal $6,000 for her 'full service package', with Ms Warnecke paying the fee in three instalments. 

A free birth, unlike a home birth where a registered midwife is present, is done without any medical professionals.

When the hearing opened on Monday, the court heard Ms Warnecke's son Axel was healthy but her condition had rapidly declined after the birth. 

A triple-zero call made at 4.30am, raising concerns about Ms Warnecke's declining health, was played to the court. 

Mr Warnecke could be heard telling the operator his wife was having trouble breathing after giving birth at home.

The phone was then passed to Ms Lal who, when asked if she was the midwife, told the operator she was a 'friend'.

She said the new mother had been bleeding but it had stopped, and that her breathing complications 'kinda comes and goes'. 

Sounds of Axel crying and Ms Warnecke's rapid breathing could be heard in the background.

The first paramedic to arrive, about ten minutes after the call, found Ms Warnecke lying on the floor, struggling to breathe, with her skin yellow and clammy.

A large blood clot was on the ground, and she was going in and out of consciousness.

She was rushed to Frankston Hospital about two hours after the birth, where she suffered multiple cardiac arrests.

Doctors performed two surgeries in an attempt to save her - a hysterectomy to stem the bleeding and a procedure to drain almost a litre of fluid that had pooled around her heart. 

The hospital exhausted its entire supply of Ms Warnecke's blood type, but she could not be saved and died from blood loss. 

Lal told the court she had no formal qualifications in relation to childbirth and had learnt through her own pregnancies. 

'I don't have any medical qualifications and don't profess to and do not provide any medical advice,' she said. 

Lal told the court she didn't regard childbirth as a 'medical matter' and said she would refuse to attend a birth if a midwife or doctor was present. 

The court heard Lal was loath to attend hospitals where she might witness women in trauma during childbirth.  

'I didn't want to put myself in a position where I would be witnessing trauma ... Obstetric violence,' she said. 

Lal said she aimed to help her clients manage the 'intensity' of childbirth. 

'99 per cent of birth is mindset. There's nothing physically you need to do to birth your baby,' she said. 

Lal downplayed her expertise in supporting mothers during childbirth, maintaining her role was purely supportive. 

'I'm an expert in my own birth experience,' she said. 

'The majority of it is just woman-to-woman support, though it's nothing formal. It's more just being there for them listening to them, supporting them in any way that they wanted,' she said. 

Lal denied she took $6,000 off Ms Warnecke to 'pretend to be her friend', telling the court she was paid for her time. 

'When I'm attending a birth, I'm attending as a friend. I'm there in a support role, like a big sister,' she insisted. 

'But you're being paid to be there to provide a service, aren't you?' Ms Ellyard replied. 

'When I'm at a birth, I'm attending as a support, like as a supportive friend, essentially. I'm not there to make a birth safer. I can't do that,' Lal said. 

Pressed on what she was being paid for, Lal said it was everything else she did before and after the birth. 

'My time. And that time was driving there and back, spending that time there, and then a lot of it is the postpartum as well. I'm cooking, I'm cleaning ... domestic duties ... So she paid me for my time,' Lal said. 

Lal said she accepted no responsibility for what happened to her clients when things went wrong. 

'I’m not telling anyone to listen to me,' she said. 

'I have a responsibility to myself, to make sure that I'm being honest about what I think and I have a responsibility to the women that I support to make sure that I'm supporting them the way that they want to be supported.'

The court heard an ambulance was only called after Ms Warnecke agreed to it after she began gasping for breath. 

'There was no way I was going to call an ambulance against her wishes,' Lal said. 

She further defended her reasons for cleaning up after the birth and refusing to cooperate with police. 

'I thought I was doing something nice by cleaning it up for [her husband],' Lal said. 

'I think that’s really unfair, honestly. Like, his wife had just died, and I thought the last thing he wants to see is a mess left from what’s caused her death. So I thought I was doing something helpful.'

Lal said she refused to cooperate with police because she feared a media pile-on. 

Lal had previously come under scrutiny in the Coroners Court after she rented out a birth pool to a freebirthing mother, whose baby subsequently died. 

'Because the last time I did, it was a birth that had absolutely nothing to do with me, and somehow it ends up with every media report saying that the baby's death was my fault,' she said. 

Lal said she 'wasn't legally required to make a statement'. 

'You knew that someone who was your friend had just passed away and you were an eyewitness to some of the events. Why wouldn't you want to make a statement to describe what you had seen?' Ms Ellyard asked.  

'I wasn't legally required to, so I opted to not,' Lal responded. 

Ms Warnecke was described in court as an intelligent and thoughtful woman who excelled at school and had a love of learning. 

After experiencing Victoria's COVID-19 lockdowns and vaccine mandates, Ms Warnecke did not want to give birth in the health system, Ms Ellyard said.

She said the expectant mother had a strong wish to avoid the 'cascade' of 'excessive' medical interventions, invasive medical tests and a C-section birth.

'She had a deep fear of birth trauma - what would happen [if there were complications] that would have...exposed her to interventions that she would not choose,' Ms Ellyard said.

'The only way to have a baby on her own terms was to look for a free birth.'

The inquest continues.