An American man who admitted causing the deaths of two Northland woman in a car crash will be sentenced only days before he is due to receive treatment for a brain tumour at home.

Thomas James Springer, whose momentary loss of concentration caused the deaths of the two women last Saturday, sat hunched and pale in the dock during his second appearance at Kaikohe Court.

Springer, aged 66, epitomised the verbal picture his lawyer Mike Dodds painted of someone who was isolated and vulnerable after being involved in tragic events in a country far from home.

On Monday, Springer pleaded guilty to three counts of careless driving; two relating to two deaths and one of injury.

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On the evening of April 30, he had driven on the wrong side of the road and crashed into an oncoming car near the Puketona and State Highway 10 junction, south of Kerikeri.

Pregnant woman Kylee-Anne Rakich, 29, of Ahipara, and Virginia Keogh, 44, of Whangarei, died in the crash. A 21-year-old man, who was driving their car, was airlifted to Whangarei Hospital in a stable condition and an 8-year-old child in the same vehicle was also taken to hospital.

Springer was back in court for sentencing yesterday by Judge Greg Davis, but the process was deferred until May 20 to give time for the victims' whanau to have input via impact statements or a restorative justice meeting.

That meeting had not yet taken place because the family felt it was too soon, given the deaths happened only a week ago, the court heard.

Mr Dodds said his client, in New Zealand on holiday from San Francisco, had serious health issues and needed to be back in the US before the end of this month for scheduled medical treatment of a brain tumour.

The lawyer successfully argued against the media being allowed to photograph Springer in court, saying it would add to his personal stress and make him publicly vulnerable.

Mr Dodds described a "wall of shame" and the likelihood Springer would be "vilified as a killer" via social media which would reproduce mainstream media images.

Judge Davis invited the media to reapply for permission to take photos at the sentencing on May 20.

Four members of the victims' whanau were present at Springer's appearance yesterday, all visibly upset.

When Judge Davis explained "RJ" (restorative justice) was an opportunity for the parties, including a witness to the crash, to meet to express their anger, sorrow and grief, a woman from the victims' family tearfully called out: "Nothing can be said that will bring my sister back".

As the court session ended and the public gallery emptied, Judge Davis asked someone to stop trying to "stare down" the defendant.