In 2011, 16.6 percent of women in Indiana reported smoking during their pregnancy; that figure is roughly two times the national average.
Smoking is one of the primary causes of infant deaths across races, it also leads to premature births, Sudden Infant Death Syndrome (SIDS), and a slew of other health problems.
Last year the Indiana State Dept. of Health (ISDH) made reducing the infant mortality rate statewide its number one priority. The Hoosier state's infant mortality rate is 7.7 deaths per 1,000 infants, higher than the national rate of 7.0 deaths per 1,000 infants.
State officials hope that by 2020 infant mortality can be reduced to 6.0 deaths per 1,000.
Indiana also ranks among the worst 10 states in the nation when it came to pregnant women smoking. Approximately 17.1 percent of Hoosier woman reportedly smoke. The rates are even higher--30 percent--when looking specifically at women on Medicaid.
The rates of pregnant smokers is significantly lower in St. Joseph and Elkhart counties. ISDH reports a rate of 11.9 percent in St. Joseph County and 13.8 percent in Elkhart County.
Rates across Indiana's 69 counties range from 3.9-35.9 percent, with the majority of counties coming in well above the national average.
Bob Bowman, director of maternal and child health at ISDH said for a long time the health department has been working by itself to reduce the number of pregnant smokers. However, Bowman hopes that partnerships with Medicaid and other groups will help the state reach its healthy goals by 2020.
ISDH started a program called Baby & Me Smoke Free. Still in its test phase, the grant-based provides incentives for expecting mothers to quit their habits.
According to Bowan, mothers are tested throughout their pregnancy to see if they have stopped smoking, if they pass, they are given vouchers for free diapers.
Other programs exist in local healthcare systems and hospitals to create a support system among pregnant women.
"When we're talking about the patches, gum and support groups and things like that, my understanding is those things really can assist an individual to quit the habit and actually not revert back to smoking while in term as well," Bowman explained.
Lack of education on the severity of smoking risks also plays a role. Bowman hopes that over the next few years a combination of education, support and government programs will further reduce the rate of infant mortality.