The death rate for women giving birth plummeted in the twentieth century. During the Georgian era the average level of maternal deaths was around 1 in 100 births. Mortality rates reached very high levels in maternity institutions in the 1800s, sometimes climbing to 40 percent of patients (see Historical mortality rates of puerperal fever). At the beginning of the 1900s, maternal death rates were around 1 in 100 for live births. Public health, technological and policy approaches are steps that can be taken to drastically reduce the global maternal death burden. For developing regions, where it has been shown that maternal mortality is greater than in developed nations, antenatal care has increased from 65% in 1990 to 83% in 2012.