Melbourne wellness influencer died from treatable childbirth complication after home birth

A Melbourne wellness influencer was found lying on the floor of her home in an altered state of consciousness beside a large blood clot in the hours before she died in hospital, an inquest has heard.

Stacey Warnecke, 30, died in September from a treatable complication after giving birth at home to her son Axel without any trained medical staff, the inquest which began on Monday into her death heard.

Her husband, Nathan Warnecke, and Melbourne birthkeeper Emily Lal, who she met online, were both present during the birth.

A birthkeeper is an unregulated birth support worker who does not have any formal medical training, and operates entirely outside the medical system. Doulas, who also don’t have formal medical training, typically support women within the conventional hospital system alongside trained medical professionals.

About 25 minutes after giving birth to Axel, she gave birth to the placenta. Her husband estimated she lost up to 1.5 litres of blood at this time, the coroner heard.

Warnecke began experiencing shortness of breath, but twice she said she did not want an ambulance to be called.

Lal told her she might be experiencing a panic attack, the coroner heard.

Approximately an hour after giving birth, Warnecke was asked for a third time if she wanted an ambulance. She said yes.

The triple-zero call, made at 4.13am, was played to the coroner. A paramedic arrived at the home within 10 minutes and quickly called for backup from a mobile intensive care unit when she found “Stacey lying on the floor between the birth pool and the couch”, counsel assisting the coroner, Rachel Ellyard, said. “The room was dark. Stacey was naked, her skin was yellow and clammy.”

Warnecke was also short of breath, breathing rapidly, appeared to be in an altered state of consciousness, and there was a large clot of blood on the floor, Ellyard said.

When intensive care paramedics arrived at 4.36am, Warnecke’s blood pressure was undetectable and they had to try to stabilise her enough following what they recognised as a massive postpartum haemorrhage to transport her to Frankston hospital for emergency care.

When she arrived at the hospital at about 5.13am, she expelled a “big gush of blood” while staff transferred her from the trolley to a bed, Ellyard said.

By 5.15am, she was in cardiac arrest.

Ellyard described the “heroic” efforts of hospital staff as they tried to manage multiple cardiac arrests and ongoing bleeding that specialists decided would require surgery, including a hysterectomy and a procedure to drain fluid from her heart.

The coroner heard it was challenging to stabilise Warnecke enough for surgery and her care required use of the entire blood supply at the hospital, with reinforcement supply called in. Staff were also challenged by the impact of ongoing CPR on her heart.

As staff worked on her, Lal provided them with details of the birth, making them suspicious her role in the birth was more than just that of a friend as she had told them, Ellyard said.

“Money changed hands” when Lal became Warnecke’s birthkeeper, Ellyard told the coroner.

After surgery, Warnecke suffered from a further cardiac arrest and died shortly after 11am.

“Ms Lal left the hospital and went back to the house to clean up,” Ellyard said.

“It might have been part of services contracted to provide this clean up, and it is not clear if any thought was given to any investigation into the circumstances of Stacey’s death that might have required the scene to be left undisturbed.”

Lal is due to give evidence to the coroner on Tuesday, on the condition she be granted protection from self-incrimination. Ellyard said Lal had not provided a statement to the court.

One clinician who treated Warnecke at Frankston hospital described in her statement how the only women she cared for who died from obstetric haemorrhage “were in the third world”, Ellyard said.

The forensic pathologist who conducted Warnecke’s autopsy, Dr Michael Burke, told the coroner that he specifically listed the cause of death as postpartum haemorrhage “in the setting of a freebirth” because it is “rare” for women to die from this when they give birth in a medical facility.

“A woman who dies from blood loss … it is eminently treatable if it’s recognised quickly and managed,” he said during his evidence on Monday.

Ellyard said while Warnecke was “her own person making her own choices”, the function of a coronial inquest is to understand if changes can be made to protect public health and prevent future deaths.

Her choice to give birth outside the health system “was not a unique one” and there are a “growing number of women making the choice to forgo traditional medical care to give birth … assisted with knowledge largely acquired online,” Ellyard said.

Ellyard said it is hard to know how many women choose unassisted freebirth because if those births go well, they don’t come to the attention of medical professionals.

“But the number of medical cases that come to the attention of medical services is increasing, with very serious and tragic outcomes,” Ellyard said.

It was placing a “significant burden on medical services when called to respond to emergencies”, Ellyard said, and in Warnecke’s case her lack of contact with the medical system meant information about any pre-existing conditions to help guide care was nonexistent.

The inquest, to be heard over the next five days, will examine many elements, including whether Warnecke would have survived her complications with earlier access to medical intervention, and the advice and sources of information she used in planning for Axel’s birth.

Ellyard said Warnecke was afraid of being pushed into receiving unnecessary and potentially traumatic interventions such as a caesarean if she gave birth in hospital.

Ellyard told the coroner that Warnecke and her husband were both concerned by vaccine mandates during the Covid-19 pandemic, and “her research led her to decide she wasn’t comfortable with ultrasounds, or testing for gestational diabetes”.

She was described to the court as a vibrant, active and educated woman who was tertiary educated as a nutritionist, and who liked to do her own research including into her pregnancy.