The landmark US supreme court case Roe v Wade turns 40 this week, marking four decades of abortion rights for American women. In those 40 years, the US and most of the western world have seen remarkable social upheavals, including incredible progress for women. Yet, abortion remains ragingly controversial in America and illegal around much of the world.

Even with "Roe" on the books, the promise of bodily autonomy remains out of reach for many women. And the central opposition to abortion rights isn't about saving babies, promoting family or protecting women; it's about controlling female sexuality and trying to return to a time when women were forced or coerced into subservience.

To anyone who has taken even a cursory look at reproductive rights activism, it's obvious that decreasing the abortion rate isn't nearly as much a concern for the pro-life movement as controlling women is. We know what leads to a low abortion rate: comprehensive sex education, affordable and available contraception, rights for women, and a progressive sexual culture. The countries with the lowest abortion rates in the world have that mix – plus legal (and often state-funded) abortion.

Outlawing abortion doesn't lead to a lower abortion rate, and some of the countries with the highest abortion rates on the planet are places where it's illegal. So if outlawing abortion doesn't mean fewer abortions, what purpose does it serve? Punishing women and making their lives miserable, apparently – illegal abortion doesn't mean fewer abortions, it means more dangerous procedures and higher maternal mortality rates. Thirteen per cent of maternal deaths around the world result from unsafe illegal abortions.

Despite knowing the key to a lower abortion rate, the so-called "pro-life" movement refuses to use it. Instead, they feign concern for babies while doing absolutely nothing to help children and everything in their power to make women's lives harder and more dangerous if those women dare to believe that they're entitled to a fulfilling sex life.

With the pro-life moniker, anti-abortion forces, it seems, are winning the rhetorical war, if not the cultural one. They've managed to stake out better rhetorical ground: by preying on American anxieties about female sexuality, they've managed to get more Americans backing their ideas in theory (though not at all in practice). While a majority of Americans don't want to see abortion outlawed, more of them identify as "pro-life" than "pro-choice".

In a lot of ways, that makes sense. "Pro-life" is much more direct than the more amorphous "pro-choice" And who's against life, anyway?

Unfortunately, while "pro-life" is a hideous misnomer, a simple term like "pro-choice" cannot encompass the gravity of bodily integrity and just how critical it is for women to have rights to our own bodies.

So, perhaps it's time to emphasize what Roe has wrought, 40 years on.

For women, the ability to control the number and spacing of your children is fundamental. It's nearly impossible to overstate just how crucial that right is: without it, we simply don't have the same prospects and abilities to live full, free lives. It's no coincidence that the dual rights to abortion and birth control ushered in some of the most profound cultural shifts in human history.

While gender equality is far from perfectly realized, women today have more rights and opportunities than ever before. We go to college and most graduate schools at the same rates as men, and are increasingly present in high-paying jobs. We are better able to leave abusive marriages and relationships. We're healthier, and so are our children – child mortality has greatly decreased, and a low child mortality rate is directly tied to reproductive healthcare and reproductive rights.

Reliable birth control and access to abortion means that we can pursue an education and work to build a stable career before getting married and reproducing – and the marriages that come later in life between two highly-educated people are by far the most stable. Among couples who have children, those who plan the pregnancies are happier than those who don't.

Between 1970 and 2009, child mortality around the world fell by half, which is largely attributable to women being better-educated and better able to make their own reproductive decisions. In the US, along with Roe came safer and earlier abortions; emergency rooms are no longer lined with women injured by illegal terminations, and abortion is now one of the safest medical procedures a woman can have.

What's not to support?

According to anti-choice forces, basically everything I just mentioned. Anti-choice groups know that reproductive rights are necessary for gender parity. They know that taking away abortion and birth control doesn't stop women from terminating pregnancies. They nonetheless oppose legal abortion, and not a single mainstream pro-life group in the United States supports birth control access.

They rightly see reproductive rights as upending traditional family structures, and creating a system where women have a wider variety of choices in terms of education, career, marriage and childbearing. As it turns out, when women have a wide array of choices, a lot of choose to pursue an education, establish their financial independence, marry whom they want and have a smaller number of children.

Men, too, have a wider array of choices: increased gender parity and planned pregnancy means that men today spend more time with their children than ever before. But delayed marriage doesn't mean delayed sex – and in fact, social coercion into early marriage never actually meant delayed sexual activity or even a stop to pre-marital sex.

The highest recorded teen pregnancy rate in the United States was in the middle of the 1950s. The difference, of course, is that those teenagers got married instead of pursuing the range of options available for young women today.

Pro-life groups believe that the best model for society is one in which men and women occupy separate and distinct roles, with the man as the family leader and breadwinner, and the woman as the domestic caretaker and helpmeet. Choice naturally threatens that model – the idealized conservative female role is not one that many women want; when they're given other options, they take them. And so pro-life groups push for legislation that will coerce women into very narrow roles, and punish them for stepping out of line.

The primary victims of the pro-life strategy are poor women. The pro-life movement has stepped up its legislative game in the past two years, introducing and passing record-breaking numbers of anti-choice laws in 2011 and keeping the victories coming in 2012. They've made it not only hard to get an abortion, but to get birth control, sex ed and health care generally.

The result is that Roe's promise of abortion rights isn't available to large swaths of the American population. Abortion is a crucial right, but it's one that most women would prefer not to exercise. We'd rather not get pregnant when we don't want to be; we'd rather wanted pregnancies didn't go tragically wrong; we'd rather not be the victims of rape or incest. It's feminists and pro-choicers, though, who are trying to take steps to actually decrease the need for abortion.

The most common reason women say they're terminating a pregnancy is economic, and poor women make up a disproportionate number of women terminating pregnancies. They also have more trouble paying for them, and roadblocks to funding mean that these women are stuck between having an abortion they can't afford and having a child that they can't support. Women are trying to make the most responsible decisions given their own often perilous financial situations, and they're being blocked at every turn.

You would think that pro-choicers and pro-lifers would find common ground in contraception access for women of all income levels, but no – it's pro-life legislators who regularly fight birth control funding. You would think that pro-choicers and pro-lifers would find common ground in the things that make it easier for women to choose to have children: paid parental leave, healthcare for low-income kids, good preschool and education programs, subsidized daycare. But no: it's pro-life legislators who regularly vote down all of these initiatives.

You would think that pro-choicers and pro-lifers would find common ground in promoting the very things that lead to stable marriages, low abortion rates and healthier kids – education, gender equality and reproductive healthcare. But again, no. Instead, pro-lifers go after Planned Parenthood – the largest provider of reproductive healthcare in America – and are openly hostile to women's rights.

Their answer? Just don't have sex until you're married, and then have as many children as God gives you.

Unfortunately, that recipe has never worked in the whole of human history. People have always had sex before marriage, and married women have always attempted to control their fertility. The pro-life model has, however, left a lot of women, men and children miserable, sick or dead.

Forty years after Roe v Wade, we know that more freedom in reproduction means more freedom in life. We know that a full range of reproductive rights means happier and healthier women, men, children and societies. We also know that safe and legal abortion is still a far-off dream – not just for women in developing countries and conservative nations, but for some of the most vulnerable Americans as well.

So, we need to talk about abortion and reproductive rights as they really are: about the value and freedom of women. On this planet, we exist only within our own bodies. To deny us the fundamental right to those bodies – to our most intimate parts, to some of our most life-altering functions – is to deny us our humanity.