The number of people struggling with substance use disorders has gone up during COVID-19, and a new study out of Washington State University COVID‑19 Infant, Maternal, and Family Health Research Collaborative suggests pregnant women are included in this group. “Mental health issues have greatly increased across all demographics of people during the pandemic, but pregnant and postpartum women were a group already vulnerable and at-risk for health and well-being issues before COVID-19,” lead author of the study Celestina Barbosa-Leiker, PhD, associate dean for research and an associate professor in the College of Nursing at Washington State University, tells Verywell. “Taken together, the added stressors caused by the pandemic are key predictors for substance use and I think it’s safe to say we’ll see more pregnant women struggling to cope and needing treatment in the months and years ahead.” Over the past year, Crystal Smith, PhD, an assistant research professor at Washington State University Elson S. Floyd College of Medicine, has been researching substance use in pregnant women and gathering insights directly from the women themselves about their experiences. Her preliminary findings illustrate that pregnant women didn’t suddenly become substance users to cope with a crisis—there’s more to it, often dating back to their pre-pregnancy mental state.