From my vantage point in Michigan, celebrations of Roe v. Wade’s 40^th anniversary have felt decidedly bittersweet. Earlier this month, Governor Snyder signed HB 5711 into law—Michigan’s anti-abortion super-bill, which will prohibit the telemed prescription of medical abortion, force all women seeking safe abortion care to undergo “coercion screenings,” and enact a number of costly regulations on abortion clinics and providers, inevitably forcing many clinics to close their doors. All of this is in a state that already required a 24-hour waiting period before obtaining an abortion, where minors cannot obtain an abortion without parental consent, and where 87 percent of counties do not have a single abortion provider. The meaning of “choice” here in Michigan—as in many other states in the country—has eroded a great deal since that day 40 years ago when the Roe decision was handed down. How did we end up here? And more importantly, how do we move forward?

Under the language of the Roe v. Wade decision as it was written in 1973, it was extremely difficult for states to pass laws restricting access to abortion care, at least during the first two trimesters of pregnancy. Though the decision fell short of guaranteeing abortion access as a right, it did not allow for state intervention in regulating abortion except in cases where such regulations could be shown to be of clear medical benefit. In 1976, the Hyde amendment dealt a massive blow to abortion access by prohibiting the use of federal Medicaid funds for abortion; in the years between Roe and Hyde, approximately 295,000 abortions annually were paid for with Medicaid funds. With Hyde’s passage, access to abortion instantly became a privilege, out of reach to many who needed it most. But it was not until the early 1990s that state legislatures gained the authority to restrict abortion in the myriad ways that have become so familiar to us today. In the 1992 Supreme Court case Planned Parenthood v. Casey, the court ruled that states were free to place regulations and restrictions on abortion access so long as those restrictions did not impose an “undue burden” on a woman’s ability to choose. State lawmakers were no longer required to argue that abortion restrictions had medical benefits; on the contrary, they became free to openly acknowledge the ideological basis behind their proposed restrictions on abortion access. Suddenly, it was open season for creating barriers between women and abortion. And the murky question of what, precisely, constitutes an “undue burden” remains open to interpretation.

At the same time as states were granted this far-reaching power, a cultural shift surrounding abortion had taken place. Twenty years after Roe, a generation had come of age taking legal abortion for granted. In the days before Roe, it was necessary for abortion-rights activists to speak of abortion in terms that were bold and affirmative. But in the years that followed, as legal abortion became a given rather than something to fight for, even those who identified as pro-choice began to increasingly speak of abortion as a necessary evil rather than celebrating it as an essential ingredient for women’s equality. Bill Clinton was lauded as the first unabashedly pro-choice president, yet he popularized the now oft-heard refrain that abortion should be “safe, legal, and rare.” Legal abortion was defended most often on the grounds that without it, women would simply be endangered by illegal abortions, either self-inflicted at the hands of “butchers.” This notion—that abortion must remain legal only because it will happen anyway, and it’s safer this way—is a far cry from the notion that women have a right to bodily autonomy, and that without access to safe abortion care, women cannot be entirely free in a world where we cannot control our own reproductive lives. Even Planned Parenthood, when threatened, tends to publicly respond by downplaying its abortion services and focusing instead on the other health services the organization provides. And it is this ambivalent treatment of abortion—as an unpleasant, shameful, but necessarily legal thing—which invites support for all manner of restrictions.

Perhaps nowhere is this ambivalence about abortion as evident as a state like Michigan. We are not a Southern state, known for our biblical conservatism—the kind of environment where extreme restrictions on abortion are expected. We are, in many ways, the quintessential Midwest: blue-collar, working-class, and characterized, if anything, by a desire to be polite and reasonable. We are a state that does not want to rock the boat, that does not want to talk about religion and politics at the dinner table. It is precisely the kind of environment where people want abortion to remain legal, but are generally uncomfortable with the topic, and are easily persuaded that abortion restrictions are simply good common sense. Though at this particular moment we are governed by both a predominantly Republican legislature and a Republican Governor, anti-choice Democrats are easily elected here, and those who do claim to be pro-choice are often still supportive of restricting access to safe abortion care. It was a democratic former Governor, James Blanchard, who signed our parental notification requirement into law. And years later, yet another Democrat, Jennifer Granholm, signed off on the “informed consent” legislation mandating 24-hour waiting periods and requiring that any woman in need of an abortion be given state-produced materials detailing the current developmental stage of the embryo or fetus she is carrying. We are a state, in other words, where the dividing line between “pro-choice” and “anti-choice” is often not so clear, and where that divide certainly does not fall neatly along partisan lines.

For many years now, even many who identify as “pro-choice” have been all too willing to accept any and all abortion restrictions so long as abortion remains at least officially legal. But what does it mean for abortion to be technically legal if it is inaccessible to the majority of women who need it? Many people today don’t realize that legal abortion did take place in America before Roe v. Wade. But obtaining one required the often traumatic and dehumanizing process of going before a hospital “abortion board” to request permission for a legal abortion. Or, alternatively, in the late sixties and early seventies, women with the resources to do so could travel to one of the states where abortion had been legalized pre-Roe. The majority of Americans do not wish to see Roe v. Wade overturned. But the restrictions we are living with today have, in essence, already returned us to a pre-Roe era: one in which legal abortion exists, but is extremely difficult to come by. The purpose of the fight for Roe was not simply to make some abortions available for some women in positions of privilege. The purpose was to make abortion equally available to all women who need them. And the state of Michigan today—along with many other states in the country—falls extremely short of this ideal.

If we are to truly defend abortion rights—not simply preserve legal abortion in an empty sense—we need to reclaim the urgency of those before us who fought to legalize it in the first place. We need to stop treating abortion as a dirty word, but instead be willing to positively affirm it as a vital component of reproductive health care. We need to stop taking abortion access for granted, and to stop living with the illusion that so long as Roe has not been overturned, abortion is available for the women who need it. And we need, finally, to reclaim the dialogue surrounding reproductive rights. Abortion access always has been, and always will be, a key component to women’s equality. And it’s time we get back to speaking boldly about abortion in terms of women’s liberation, not fetal personhood.

If there were actual, serious talk of outright banning abortion in America, I believe there would be a massive outcry of resistance. But we need to realize that, at least in many states, the situation is just this dire. If we are to build the kind of social movement that’s strong enough to fight back against these attacks on reproductive freedom, we must begin by fully recognizing just how serious the consequences of these restrictions are. If we want to honor the legacy of Roe, let’s do so by remembering the spirit and the intent of those who fought for it. Let’s not continue to believe we are honoring Roe by sitting by and allowing it to be stripped of all real meaning. “Choice” means nothing in a world where there is no access. As Michigan faces a future with few remaining clinics, higher abortion costs, and a rapidly increasing list of obstacles women must pass through before being permitted to obtain an abortion, that world without choice is not some far off, conservative dystopia. It is here now. And we must first recognize the severity of the situation we’re in if we are to find a way out.