What does a good abortion look like? A few months ago, Emily Letts, a 25-year-old American clinic worker, filmed her surgical abortion and posted the video on the internet. In the clip, Letts smiles and hums throughout the procedure, which she chose to have simply because she did not want to bear a child. “I feel good,” she remarks when it’s over, shattering generations of anxiety and fear-mongering around reproductive choice with three simple words.

The idea that abortion might be a positive choice is still taboo. For some, the only way it can be countenanced is if the pregnancy is an immediate threat to life or the result of rape – meaning that the woman involved didn’t want to have sex and as such does not deserve to be punished for the crime of acting on desire as a female. Even then, the person having the abortion is expected to be sorry for ever, to weep and agonise over the decision. In Britain, the Abortion Act 1967 obliges anyone seeking a termination to justify why continuing with a pregnancy poses a threat to her health and well-being or that of her existing offspring. “Because I don’t want to be pregnant” simply isn’t enough.

Hence the furore over the glamour model Josie Cunningham’s recent announcement, through the eyebrow-raising medium of the British tabloid press, that she is planning to terminate her pregnancy in order to have a shot at appearing on reality television. The national and international gossip media scrambled to excoriate Cunningham: this was the epitome of selfishness, a woman who would boast of having an abortion to further her career. We live in a society that fetishises “choice” while denying half the population the most fundamental choice of all – the choice over the autonomy of one’s body.

Women in Northern Ireland, where the Abortion Act 1967 does not apply, have just learned that – despite paying towards the NHS through their taxes – they will continue to be denied an abortion unless they can travel to England and fund it themselves. As a result of a high court ruling, hundreds of women each year will still find themselves having to take cheap red-eye flights to Heathrow and Manchester, scared and alone, to have procedures they may have gone into debt to afford.

In Northern Ireland, as in the rest of the world, the prospect of women having full control over their reproductive potential – the notion that we might be able to decide, without shame or censure, whether and when and if we have children or not – provokes fear among the powerful. When abortion is discussed in public, it is almost always in terms of individual morality or, more usually, of moral lapses on the part of whatever selfish, slutty women are demanding basic human rights this week. It is rarely discussed in terms of structural and economic inequality. Yet reproductive inequality remains the material basis for women’s second-class status in society. It affects every aspect of our future.

Consider, as an example, the controversy over the rise of “social surrogacies” – rich women paying poor women to go through pregnancy and childbirth on their behalf. The horrified response to this idea belies how men do the same thing: arrange for women to bear, carry and, indeed, raise children on their behalf so that they can get on with their careers uninterrupted. That’s the material basis of gender inequality and it must be discussed honestly as a matter of structural injustice, not individual morality.

Abortion, motherhood and reproductive health care remain fraught issues, as women’s demand for basic control over our bodies and destinies pulls ever further away from official public policy. In countries such as Ireland, Spain and the US, women’s bodies remain the territory on which the patriarchal right wing fights its battle for moral dominance.

Abortion can be a difficult, painful decision – if, for example, you would quite like to have a baby but are in no position to support one because “single mother” is still a synonym for “poor and shunned” and pregnancy discrimination is rampant in this treacherous post-crash job market. But abortion can also be a simple decision. It does not have to involve years of regret or, as Emily Letts bravely demonstrated, any regret at all.

So here, in case it wasn’t clear, is my position. Abortion should be available on demand, without restrictions, for everyone who needs it. I believe that while society still places limits on what a woman may or may not do with her own body, while women’s sexuality and reproduction are still in effect controlled by the state, any discussion of equality or empowerment is a joke. Nobody should have to play the frightened victim to make basic choices about her future. It should be enough to turn up at a clinic and say, “I don’t want this,” or, “I’ve changed my mind.”

And there’s more. If there were real choice, real equality, pregnancy, childbirth and motherhood would not come with enormous socio-economic penalties for all but the richest women. Society should provide support for all parents, single and partnered, in and out of work, rather than forcing them to live on a pittance, under constant threat of eviction, and shaming them as “scroungers”.

That’s what real choice would look like. And the thing about giving people choices is that inevitably a few of them will make poor choices, choices we might not approve of. Many people have religious or personal reasons for disapproving of abortion and they are free, as they always have been, not to have one themselves. Yet it’s time to change the terms of the debate. It’s time to demand reproductive rights for everyone – without apology.