The maternal mortality rate in the United States was worse in 2015 than in 1990, and is now double that of Canada’s, a global maternal mortality survey by the United Nations and the World Bank published Thursday showed. The U.S. average rose to 14 mothers’ deaths per 100,000 live births from 12 a quarter century ago. It is one of just 13 countries, including Venezuela, North Korea and Zimbabwe, to have a worse rate, Reuters reported. Canada’s rate has remained stable over the years at seven deaths per 100,000 births.

Globally, approximately 303,000 women died from complications during pregnancy in 2015 or up to six weeks after giving birth, down 44 percent from 1990's total of 532,000. But the progress has been “uneven,” with around 99 percent of those deaths occurring in developing countries, said Lale Say, reproductive health and research coordinator at the World Health Organization.

Although WHO officials said the results show “huge progress,” just nine countries hit targets set by the U.N. and more intervention is needed in developing countries to bring down the rates further. “Many countries with high maternal death rates will make little progress, or will fall behind, over the next 15 years if we don’t improve the current number of available midwives and other health workers with midwifery skills,” Babatunde Osotimehin, executive director of the U.N. Population Fund, told the BBC.

The survey also found Belarus is now one the world’s safest places to have a baby after cutting its maternal mortality rate to four from 33, falling just behind Iceland, Finland, Poland and Greece, where rates are all three deaths per 100,000 births.

The global average is 216 deaths, which the U.N. seeks to bring down to 70 in the next 15 years, with no country averaging more than 140.