Health officials in the state of Kanpur in India are concerned with the high level maternal mortality rate (MMR).
Figures from a sample registration survey carried out in 2006 showed that MMR was 440 per 100,000 live births in the state.
In other states the figure was much lower, such as in Kerala and Tamil Nadu, where MMR was 95 and 111 per 100,000 live births respectively.
According to the survey, a number of reasons resulted in the high level of MMR in Kanpur.
These included haemorrhage, sepsis, hypertension, obstructed labour and abortion.
Dr Ashok Mishra, Kanpur's chief medical officer, said a large number of births are delivered by untrained personnel, which contributed to the problem.
He said: "Maternal death usually occurs between the third trimester of pregnancy and first week after delivery. There are more chances of a woman's death within first two days after the delivery.
"A large number of deliveries are conducted by untrained personnel. Deaths are mostly related to obstetric complications including post partum haemorrhage, infections and prolonged or obstructed labour. Also, a prime reason has been the lack of institutional deliveries."
Copyright © Press Association 2010