An ex-midwife on trial over the deaths of two babies during homebirths failed to warn mothers of risks and acted calmly as the children died, an Adelaide court has heard.
Lisa Jane Barrett, 52, has pleaded not guilty to two counts of manslaughter over the deaths of Tully Kavanagh in 2011 and another baby in 2012.
Opening the prosecution case on Friday, Sandi McDonald SC told the Supreme Court Barrett discouraged Tully's mother, Sarah Kerr, from giving birth in a hospital, despite the fact she was pregnant with twins.
Ms McDonald said Barrett downplayed the significant risks associated with a twin homebirth and manipulated a fear of hospitals Ms Kerr had developed after the traumatic birth of a previous child.
Ms Kerr gave birth to a healthy first twin, a girl, but Barrett was "calm, composed and almost casual in her approach" as the heartbeat of the second twin dramatically slowed.
Ms McDonald said Barrett eventually went outside the house and smoked a cigarette while she called the hospital, but an ambulance was not called.
"This was a medical emergency, the baby was in a perilous state and, consequently, every second counted," she said.
"At no stage did the accused make Ms Kerr or Mr Kavanagh aware of the danger the baby was in."
Ms McDonald said Tully was born in the car and, by the time he reached the hospital, he was not breathing and had no heartbeat.
He was put on a ventilator and moved to the neo-natal intensive care unit, but died two days later.
The court heard the second baby was born to a woman who had several health issues that put the birth at high risk of complications, and the baby was in the breach position.
The child was not breathing when paramedics arrived at the house, was later diagnosed with a brain injury and "a very poor long-term prognosis", and died shortly after birth.
Ms McDonald said Barrett had been deregistered by the Nursing and Midwifery Board of Australia in 2011 but continued to offer advice and attend home births.
"The accused came to believe her own publicity about her ability to deliver any baby, regardless of risk factors, in a home environment," she said.
The mothers of both children and four medical experts are expected to give evidence during the eight-week long trial.
The trial continues before Justice Ann Vanstone in the absence of a jury.
Australian Associated Press