Women are dying from complicated pregnancies and childbirth at almost the same rate they were in 1990, and the vast majority of deaths are occurring in sub-Saharan Africa and south Asia, a report said Friday. The report by three U.N. agencies and the World Bank estimated that 536,000 women died due to complications in pregnancy or childbirth in 2005, compared to 576,000 in 1990. That represents an average annual decline of less than 1 percent - far below the 5.5 percent needed to achieve a U.N. goal of reducing the ratio by 75 percent by 2015, it said. Ninety-nine percent of the deaths occurred in developing countries, according to the report.

"In this 21st century no woman should die giving life. Millions of lives are at stake and we must act now," said Thoraya Ahmed Obaid, executive director of the U.N. Population Fund, one of the agencies behind the report.

The report called for the prevention of unplanned pregnancies and unsafe abortions to achieve the Millennium Development Goal set by world leaders at a U.N. summit in 2000. It also called for high-quality pregnancy and delivery care.

Obaid said "three simple interventions" are needed - skilled birth attendants, emergency obstetric care, and family planning.

In Africa, less than 50 percent of births are attended by a skilled health worker, the report said. That's far below the global target of ensuring that at least 90 percent of births worldwide are attended by skilled health personnel by 2015, it said.

According to the report, 270,000 maternal deaths in 2005 occurred in sub-Saharan Africa, followed by South Asia with 188,000. The two regions accounted for 86 percent of the total.

The report gave the estimated number of maternal deaths per 100,000 live births in 171 countries in 2005.

The highest estimated rate was in Sierra Leone at 2,100 deaths per 100,000 live births, followed by Afghanistan and Niger at 1,800.

The United States had an estimated rate of 11 deaths for every 100,000 births - higher than most European countries and Japan. The lowest rate was in Ireland at 1 death per 100,000 births.

The report was based on estimates by the World Health Organization, the U.N. Children's Fund, the U.N. Population Fund and the World Bank.