PHILADELPHIA (AP) - A Philadelphia abortion provider was to go on trial for murder in a case that could send the 72-year-old to death row.
Dr. Kermit Gosnell is charged with running a rogue abortion clinic in West Philadelphia that allegedly performed illegal, late-term abortions and injured countless women through lax medical procedures.
Gosnell, 72, has pleaded not guilty in the deaths of a female patient and seven babies allegedly born alive. Eight clinic workers charged with him have pleaded guilty, including his wife, a beautician accused of helping him perform stealth third-term abortions on Sundays.
His trial begins on Monday.
A devastating 2011 grand jury report describes nearly unfathomable conditions: foetal body parts stored in glass jars and staff refrigerators; filthy, blood-stained operating areas; women and teens maimed after Gosnell perforated a uterus or colon.
"Anybody walking into that clinic should have known immediately that it should have been shut down," said Mr Bernard Smalley, a lawyer for the family of Karnamaya Mongar, the 41-year-old refugee who died after being given too much anesthesia and pain medication during a 2009 abortion.
Philadelphia prosecutors accuse state and local authorities of turning a blind eye to laws requiring regular inspections. And they say the occasional complaints that trickled in, one after an earlier patient death, went nowhere.
"We think the reason no one acted is because the women in question were poor and of colour, because the victims were infants without identities, and because the subject was the political football of abortion," said the 2011 grand jury report, released by Philadelphia District Attorney Seth Williams.
The case prompted state lawmakers to tighten clinic regulations. Pennsylvania abortion clinics now have to meet the same standards of care required by ambulatory surgical facilities, a rule other states are also adopting.
The Guttmacher Institute, which supports abortion rights and tracks women's health laws, believes abortion foes are capitalising on the Gosnell case.
"They're using the Gosnell example in the argument to promote clinic regulations," policy analyst Elizabeth Nash said.
"But in the past couple of years, the heat has been turned up under abortion restrictions in general."
Despite the new rules, which took effect in June, nearly all of the state's abortion centers have remained open, state health officials said. The most recent state data shows that 36,280 abortions were performed in 2011, down somewhat from 37,284 in 2009. The highest annual total on record is 65,777 in 1980; the lowest is 34,494 in 1999.
Gosnell's one remaining co-defendant, medical school graduate Eileen O'Neill of Phoenixville, allegedly practiced medicine without a licence at the clinic. She is charged with theft by deception, conspiracy and other charges.