Maternity care at almost three-quarters of local NHS groups needs to improve, new figures show.
In total, 209 Clinical Commissioning Groups (CCGs) were rated of which 144 "need improvement," with 11 registering the "greatest need for improvement," according NHS England.
Just one group, West Kent, was ranked as "top performing" with a further 53 classed as "performing well".
The figures, released on Thursday, have been hailed as a "positive step" for transparency by the midwives' trade union.
Maternity was assessed in four areas to give a "broad representation" of care: stillbirth and neonatal mortality rates, maternal smoking rate at delivery, experience and choice.
Cathy Warwick, chief executive of the Royal College of Midwives, said she welcomed the "openness and transparency in publishing these ratings," but was "concerned about the number of services requiring improvement".
She added: "This is a positive step and one that could help women to be informed about the quality of services where they live and empower them to make more informed decisions about their care.
"Hopefully these ratings will be used to help CCGs learn from the best and to improve quality where that is shown to be needed."
Dr Matthew Jolly, from NHS England, said: "It has never been safer to give birth in this country and the vast majority of women report a good experience, but there is more that we can do.
"The ratings published today will help local areas identify where they are doing well and importantly where improvements can be made – helping to ensure women and their families have a good experience wherever they live."
NHS England said it will offer a "comprehensive support package" to help CCGs in need of improvement.
The stillbirth and neonatal mortality figures came from 2014 ONS data while the maternal smoking indicator used NHS Digital data.
The experience and choice indicators were based on answers to the 2015 Care Quality Commission National Maternity Services Survey.
Elizabeth Duff, from the National Childbirth Trust (NCT), said: "We're pleased to see NHS England is delivering on its commitment to be more transparent about CCGs' performances and this is a positive step forward.
"These figures starkly highlight areas where improvement is needed.
"Parents shouldn't use these figures alone to decide where to have a baby. They are baseline ratings which don't take into account every aspect of care."