On January 21, I had the joy and privilege of marching in Washington, D.C., alongside half-a-million other people crying out for equal rights for all women. Amid a sea of pointy-eared pink knit hats, I proudly carried a sign that read “MAKE ABORTION GREAT AGAIN.”

People pointed and giggled, gave me high fives, or stared in confusion. On social media, my sign received some mixed responses. Even some pro-choice friends said that the sentiment was a counterproductive joke and that abortion was never meant to be great, only necessary.

I disagree. My sign and the idea it expressed were not jokes, and I do think abortion is great when it is a safe, legal, and accessible option for all people.

As a family physician and abortion provider in the Bay Area, I see patients choose abortion for many different reasons. A woman who desperately wanted a child chose to have a later abortion when she learned that her baby would be born, and quickly die, without a fully formed brain. Another woman who had a 6-month-old child with Down syndrome chose to have an abortion when her highly effective birth control failed. There was also a woman who was trying to leave her abusive husband and was scared of what he would do if he found out she was pregnant; she chose to end her pregnancy with medication abortion. A pregnant 16-year-old didn’t want to finish high school with a child. And a mother with two kids chose to have an abortion simply because it was not the right time in her life to have another baby.

Because I work in a state that doesn’t single out abortion for unnecessary restrictions and in a practice where medical care isn’t dictated by religious affiliation, I could provide each of these women with nonjudgmental and fact-based pregnancy options counseling. They could make an appointment at a clinic close to home. My patients could get their counseling, ultrasound, and abortion all in the same day, often covered by Medicaid or private insurance.

For each of these women, abortion was indeed great. Abortion spared the first patient the emotional and physical pain of having to deliver a baby who wouldn’t live. The second patient was able to focus her limited resources on meeting the needs of the baby she already had, a child with significant physical and developmental disabilities. For women experiencing intimate partner violence, pregnancy can be an especially dangerous time. Being forced to continue this pregnancy would likely have trapped my third patient in her abusive relationship. The 16-year-old and the mother of two were both able to decide the best path for themselves and their current or future families.

For some of my patients, choosing abortion is a hard and sad decision. But for many others, it is simply a decision—and that’s okay, too.

This is not what abortion opponents tell us. They would have us believe that abortion plummets women into depression and a lifetime of negative consequences—which simply isn’t true. 

Those same anti-abortion forces have made sure that not all women are as lucky as my patients. According to the Guttmacher Institute, more than half of U.S. women of reproductive age live in states that are hostile or extremely hostile to abortion rights. Because of targeted restrictions on abortion providers, an increasing number of states, including my home state of West Virginia, are left with only one abortion clinic.

Combined with an increasing number of laws that impose waiting periods, mandate parental notification, limit the gestational age for abortion, and ban insurance coverage for abortion, the dearth of clinics means that many women are essentially left without access to abortion. For these women, Roe v. Wade is meaningless. Abortion might as well be illegal. And this is exactly what the anti-choice movement wants. They are winning.

In order for women to have full economic and social equality, we must have access to the tools needed to decide how, when, and if we parent. We must fight back against the onslaught of state-level and federal restrictions on abortion.

We can start by not being swayed or cowed by the notion that abortion is a hard but necessary option for a few “unfortunate” women. This rhetoric has been adopted even by legislators neutral to or supportive of reproductive choice. This language isn’t neutral. Saying that abortion is a devastating choice or “should be rare” ignores the oft-cited fact that one in three women in the United States will have an abortion by age 45, and it also implies that abortion signals a personal, moral, or physical failing.

This stigma affects women who consider or choose abortion. My patients may feel a lot of emotions—sadness, relief, guilt, happiness, anger—but societally imposed shame should not be one of them.

Abortion is great! And a United States where women are forced into unsafe abortions or unwelcome (or unsafe) childbirth is not great at all.