A senior clinician reported a birthkeeper to police the same day one of her clients died after giving birth at home – something the senior clinician said he had not done before.

The evidence was heard during the third day of the inquest into the death of 30-year-old wellness influencer Stacey Warnecke, who died on 29 September in Frankston hospital in Melbourne. She had paid Emily Lal $6,000 to support her to have a freebirth at home without any clinically trained staff involved.

Lal described her role at the time as a “birthkeeper”. Birthkeepers have no medical training and operate outside the medical system, and do not believe in the involvement of trained clinical staff throughout pregnancy.

Lal on Tuesday told the inquest that her role was not a medical one, nor was it to keep Warnecke safe.

Rather, she was acting primarily as a friend when she was hired and attended Warnecke’s birth at home, Lal said. She also said it was not her role to call an ambulance unless specifically asked to by any mother she was hired by.

Warnecke gave birth to her son shortly after 3am, and to the placenta about 20-25 minutes after that, when she suffered a bleed. At this point she said she needed to lie down, the court heard earlier.

She became short of breath and panicked, and Lal told her she might be suffering from a panic attack, the inquest heard.

She had in fact suffered a massive postpartum hemmorhahge, which Frankston Hospital Director of Obstetrics and Gynaecology Nisha Khot told the inquest on Wednesday was treatable and was “very rare” for women to die from when they give birth in hospital, or with a midwife present at a home birth.

After a period of struggling to breathe, Warnecke told Lal “I’m bleeding”, but Lal looked between her legs and told her she wasn’t bleeding anymore, the inquest heard.

Khot described how internal bleeding can occur following a haemorrhage and that visible blood is just one of many signs of haemorrhage clinicians are trained to look for.

The executive director of medical services & clinical governance at Bayside Peninsula Health, associate professor Shyaman Menon described the efforts of clinical staff as they tried to save Warnecke’s life.

By the time Warnecke arrived at hospital approximately two hours after giving birth, her heart was also struggling and she had suffered from numerous cardiac arrests. Lal had asked Warnecke three times if she wanted an ambulance, but only called the third time after Warnecke said “yes”.

A paramedic who gave a statement to the coroner described how Warnecke was agitated, breathing rapidly and in an altered state of consciousness by the time she arrived.

Surgeons needed to perform both a hysterectomy to stop the bleeding and a procedure to drain the fluid from her heart, Menon said. Lal told the inquest she only attended the hospital because Warnecke’s husband, Nathan, had accidentally taken her phone instead of his own.

Menon said clinical staff were concerned by what Lal told them because, despite presenting herself as a friend, she was using language that indicated she may have been responsible for treatment or care.

“The feeling was the language was used was probably more than what a general public member would actually understand… and which raised a concern whether there was someone who actually had an element of knowledge provided during that care,” he said.

Concerns were raised by staff at a review meeting held in the hours after Warnecke’s death. That prompted him to go on the same day to Frankston police station to make a statement, which he told the coroner he had not done before.

“The basis of why I went to the police on behalf of Bayside Health Peninsula [was] to make a report from a public health and safety perspective.”

Lal was approached by police to give a statement, but told the inquest on Tuesday she did not do so.

“I wasn’t legally required to,” she said.

The inquest continues.