More than 64,000 women and girls became pregnant because of rape in states that implemented abortion bans after Roe v. Wade was overruled, according to a new research estimate published online Wednesday.

The research letter, published by JAMA Internal Medicine and headed up by the medical director at Planned Parenthood of Montana, estimated that nearly 520,000 rapes were associated with 64,565 pregnancies across 14 states, most of which had no exceptions that allowed for terminations of pregnancies that occurred as a result of rape.

Texas topped the list, with 45% of the rape-related pregnancies occurring within the state, researchers estimated. Ninety-one percent of the estimated rape-related pregnancies took place in states without exceptions for rape, according to the researchers.

“Few (if any)” of the women and girls who became pregnant because of rape “obtained in-state abortions legally, suggesting that rape exceptions fail to provide reasonable access to abortion for survivors,” the research letter said.

Abortion rape exceptions can be rendered “virtually meaningless” because of rape reporting requirements, said Dr. David Himmelstein, who co-authored the research and teaches at the School of Urban Public Health at Hunter College.

“I think, frankly, those are window dressing exceptions,” Himmelstein said. “They’re not actually exceptions … [that are] effective in making abortion available in cases of rape.”

The researchers used data from the Centers for Disease Control and Prevention, the Bureau of Justice Statistics and the FBI to create their estimates.

The numbers were “really shockingly high,” said one of the authors of the research, Dr. Kari White, an executive and scientific director at the pro-abortion-rights group Resound Research for Reproductive Health.

“Unfortunately, I think that just really reflects how common rape is in the United States,” she said in an interview.

Sexual violence affects millions of people every year in the U.S., according to the CDC. Over half of women and nearly 1 in 3 men have experienced sexual violence involving physical contact, according to the CDC.

Abortion bans are also “really interfering with people’s abilities to make decisions about their reproductive health care that are very personal,” White said.

“And particularly for survivors of rape, you know, they’ve already had their reproductive autonomy compromised, and state policy is further getting in the way of them making decisions about their health care,” she added.

Twelve states are enforcing almost-complete bans on abortion, according to the Guttmacher Institute, a pro-abortion-rights organization. While it is not banned in Wisconsin or North Dakota, abortion access has been complicated in the two states by legal uncertainty in Wisconsin and the decision by North Dakota’s only abortion clinic to move, the institute said.

The Supreme Court overruled the landmark decision Roe v. Wade in June 2022, ending decades of precedent. The court’s decision in Dobbs v. Jackson Women’s Health Organization also ushered in a wave of states restricting or banning abortion.

Since the Dobbs decision, there has been an increase in patients traveling across state lines to get abortions. During the first half of 2023, nearly 1 in 5 people seeking abortions traveled to other states for abortion care, according to research the Guttmacher Institute published in December.

President Joe Biden has discussed expanding reproductive rights as part of his re-election bid; he traveled to Virginia on Tuesday to reiterate his position that protections provided by Roe v. Wade should be enshrined into law. He has repeatedly said that if Congress passes a bill to restore abortion protections that had been provided by Roe, he would sign it.