Missouri’s maternal mortality rates are one of the worst in the country according to a new report by the United State’s Health Foundation. According to the health of Women and Children report, the national average for maternal deaths during pregnancy is 20 deaths per every 100,000 births. Missouri’s average is 28 deaths per every 100,000 births making it one of ten states with the highest mortality rates. The report says many deaths are cardiac related. Missouri’s high rates of smoking and obesity increase the risk of these complications during pregnancy.