More women die in childbirth in the United States than in Europe as a whole on average and some developing nations, according to a report released by the United Nations and the World Bank.
The United States was ranked 41st among 171 countries, according to the report, which was published in a special issue of Lancet focused on women's health.
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One in 4,800 U.S. women dies from complications of pregnancy or childbirth, the same as Belarus and just slightly better than Serbia's rate of one in 4,500. However, even some developing countries such as Bosnia fare better than the U.S., according to the report.
Ireland has the best maternal death rate, with just one out of 47,600 women dying in childbirth. Bosnia had the second-lowest rate, with 1 in 29,000 women dying during pregnancy and childbirth.
Most U.S. pregnancy-related deaths stem from blood clots, hemorrhage, complications of medical conditions and pre-eclampsia.
The death rate among U.S. black women was nearly four times the rate of white women at 34.7 deaths per 100,000 live births for blacks and 9.3 per 100,000 live births for whites.
The report cited America's complacent attitude toward childbirth as another contributor toward the U.S. maternal death rate.
"Most believe it is now more or less routine and no longer the deadly risk it was for their grandmothers," the U.N.-led group said in a statement.
The four lowest-ranked countries in the report are Niger with a rate of one in seven maternal deaths, Afghanistan and Sierra Leone with one in eight and Chad with a rate of one in 11.