Controversy over the practice of UC has largely centered over whether it is, as claimed by proponents, a safe method of childbirth. Critics of UC, such as the Society of Obstetricians and Gynaecologists of Canada (SOGC), claim that unassisted childbirth is quite unsafe, and that those who engage in it are "courting danger". A spokesperson for the American College of Obstetricians and Gynecologists issued a one-word assessment of freebirth: "dangerous". The SOGC notes that more than 500,000 women worldwide die annually from complications during childbirth, and that even in developed countries, in which expectant mothers generally receive complete prenatal care, as many as 15% of all births involve potentially fatal complications. In poor countries in which there are conditions of malnutrition and taboos surrounding childbirth or there is a lack of qualified birth attendants, rates of maternal and infant mortality and complications such as fistula are much higher, with disparities in death rates from childbirth between developed and developing countries approaching two orders of magnitude. Critics also point out the high rates of complication and death arising from childbirth that existed before the development of modern medicine: between 10 and 15 deaths per 1000 births.