The death rate of women giving birth in the US is worse than in 40 other countries, including nearly all the industrialised countries, Amnesty International said today in a report that describes the country's approach to maternity care as "disgraceful and scandalous".

According to the World Health Organisation (WHO), the likelihood of a woman dying in childbirth in the US is five times greater than in Greece.

The US has some of the best medical care in the world, but Amnesty says the lives of poor, uninsured, African American and Native American women are put at risk by neglect.

"This country's extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful," said US Amnesty executive director Larry Cox. "Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors. Women should not die in the richest country on earth from preventable complications and emergencies.

"Mothers die not because the United States can't provide good care, but because it lacks the political will to make sure good care is available to all women."

The US ranks 41st in the WHO's league table of maternal mortality, with a risk of women dying in childbirth at one in 4,800. Top of the league is Ireland with one in 47,600, which has partly to do with the small population, followed by Bosnia and Herzegovina and then Italy and Greece. The UK ranks 26th with a risk of one in 8,200.

The damning report comes in a year of unprecedented international effort to reduce the death rate among mothers in developing countries, which will include a major conference called Women Deliver in Washington in the summer. The cause has been taken up by Secretary of State Hillary Clinton as well as Sarah Brown in the UK.

That context makes the Amnesty report all the more shocking. Death rates among women in pregnancy and labour have doubled in the US from 6.6 per 100,000 in 1987 to 13.3 per 100,000 in 2006.

Although some of the increase is due to better data collection, there is no doubt that deaths have risen while the technology and know-how to prevent them has improved.

Whatever form they finally take, President Obama's healthcare reforms will not resolve the crisis of unavailable and unaffordable maternal care, says Amnesty.

The reform proposals will still leave millions without cover and do not address race discrimination, systemic failures and lack of accountability. Amnesty is urging Obama to set up an office of maternal health to address the issues directly.

The report, Deadly Delivery, reveals that severe pregnancy-related complications that nearly cause death – known as near misses – are rising at an alarming rate, increasing by 25% since 1998. Currently nearly 34,000 women annually experience a "near miss" during delivery.

Discrimination is costing lives, it says. Women who are poor, who are African American, Native American or immigrants and those who do not speak English face serious barriers in obtaining care. One in four women do not get the antenatal check-ups they need, which can warn of pregnancy complications. Among African American and Native American women, one in three go without antenatal care.

One in five women of reproductive age (15-44), amounting to about 13 million, are not insured. Half of them are women of colour, says the report. The burdensome bureaucratic procedures involved in Medicaid enrolment delay women access to check-ups, risking their lives.

Nearly a third of all deliveries in the US are by caesarean section, which is a rate twice as high as that recommended by the WHO. Caesareans carry a risk of death three times as high as natural birth.

Amnesty says that the death rate in the US is probably even higher than it appears, because there is no federal requirement for the reporting of deaths in childbirth.