An American tourist who caused a fatal crash that killed two women, one of whom was eight months pregnant, near Kerikeri last weekend is suffering from a brain tumour, a court has been told.

Thomas Springer, 66, appeared in the Kaikohe District Court this morning, after admitting two charges of careless driving causing death, and one of causing injury.

Virginia Keogh and Kylee Rakich died at the scene when Springer drove on the right hand side of the road and hit their vehicle head-on, near Puketona.

The tourist's lawyer, Mike Dodds, told the court his client was acutely aware of the grief he had caused; wanted to atone for it and would not forgive himself any time soon.

He said Springer has been diagnosed with a brain tumour and is due back in the United States later this month for medical tests.

Judge Greg Davis remanded Springer on bail for two weeks and invited relatives of the dead women to consider a restorative justice hui.