All home births constitute child endangerment and should be outlawed ("Details on midwife unaired in Hopkins malpractice case," July 15). We do not let parents leave young children at home unattended. We demand lifeguards at public swimming pools. Cars must stop for school buses. Infants and children require car seats and seat belts. We all know that our children are usually safe if we do otherwise but want to protect them all of the time, not most of the time. It is ludicrous to deliver babies at home.

As a pediatrician for 41 years who has cared for damaged babies following unexpected birthing accidents, I know all too well that birth accidents sometimes happen no matter how smooth the pregnancy. When I was in pediatric training many years ago at Columbia Presbyterian Hospital in New York City, the hospital spent millions of dollars to provide a transitional nursery on the delivery floor because it was deemed that the neonatal intensive care nursery, three floors and an elevator ride away, was too far for a newborn in need of urgent care.

If a hospital realizes how important immediate, lifesaving neonatal care is, how much more obvious is it that a home birth, even a mile away from the expertise of a hospital, is unacceptable.

Michael Andorsky M.D., Owings Mills