Dr. Kermit Gosnell was also charged with murder in the death of a woman who suffered an overdose of painkillers while awaiting an abortion.
In a nearly 300-page grand jury report filled with ghastly, stomach-turning detail, prosecutors said Pennsylvania regulators ignored complaints of barbaric conditions at Gosnell's clinic, which catered to poor, immigrant and minority women in the city's impoverished West Philadelphia section.
Prosecutors called the case a "complete regulatory collapse." "Pennsylvania is not a Third World country," the district attorney's office declared in the report. "There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago."
Gosnell, 69, was arrested and charged with eight counts of murder in all. Nine of Gosnell's employees - including his wife, a cosmetologist who authorities say performed abortions - also were charged.
RELATED: Photos of the suspects in this case
Prosecutors said Gosnell made millions of dollars over three decades performing thousands of dangerous abortions, many of them illegal late-term procedures. His clinic had no trained nurses or medical staff other than Gosnell, a family physician not certified in obstetrics or gynecology, prosecutors said.
At least two women died from the procedures, while scores more suffered perforated bowels, cervixes and uteruses, authorities said.
Under Pennsylvania law, abortions are illegal after 24 weeks of pregnancy, or just under six months, and most doctors won't perform them after 20 weeks because of the risks, prosecutors said.
In a typical late-term abortion, the fetus is dismembered in the uterus and then removed in pieces. That is more common than the procedure opponents call "partial-birth abortion," in which the fetus is partially extracted before being destroyed. Prosecutors said Gosnell instead delivered many of the babies alive.
He "induced labor, forced the live birth of viable babies in the sixth, seventh, eighth month of pregnancy and then killed those babies by cutting into the back of the neck with scissors and severing their spinal cord," District Attorney Seth Williams said. Gosnell referred to it as "snipping," prosecutors said.
Prosecutors estimated Gosnell ended hundreds of pregnancies by cutting the spinal cords, but they said they couldn't prosecute more cases because he destroyed files.
"These killings became so routine that no one could put an exact number on them," the grand jury report said. "They were considered 'standard procedure."'
Defense attorney William J. Brennan, who represented Gosnell during the investigation, said: "Obviously, these allegations are very, very serious."
The grand jury report came out a day after new Republican Gov. Tom Corbett took office. Spokesman Kevin Harley pledged that Corbett's administration, through his new health secretary, would do more to oversee such clinics.
"What needs to be done is regulators, whether on the local or state or federal level, need to properly regulate, inspect and do their jobs," Harley said. "The safety of our citizens should be first and foremost."
Authorities raided Gosnell's clinic early last year in search of drug violations and stumbled upon "a house of horrors," Williams said. Bags and bottles holding aborted fetuses "were scattered throughout the building," the district attorney said. "There were jars, lining shelves, with severed feet that he kept for no medical purpose."
Prosecutors said the place reeked of cat urine because of the animals that were allowed to roam freely, furniture and blankets were stained with blood, instruments were not properly sterilized, and disposable medical supplies were used over and over.
Gosnell didn't advertise, but word got around. Women came from across the city, state and region for illegal late-term abortions, authorities said. They paid $325 for first-trimester abortions and $1,600 to $3,000 for abortions up to 30 weeks. The clinic took in $10,000 to $15,000 a day, authorities said.
"People knew near and far that if you needed a late-term abortion you could go see Dr. Gosnell," Williams said. White women from the suburbs were ushered into a separate, slightly cleaner area because Gosnell believed they were more likely to file complaints, Williams said.
Few if any of the sedated patients knew their babies had been delivered alive and then killed, prosecutors said. Many were first-time mothers who were told they were 24 weeks pregnant, even if they were much further along, authorities said.
Prosecutors said Gosnell falsified the ultrasound examinations that determine how far along a pregnancy is, teaching his staff to hold the probe in such a way that the fetus would look smaller. Gosnell sometimes joked about the babies, saying one was so large he could "walk me to the bus stop," according to the report.
State regulators ignored complaints about Gosnell and the 46 lawsuits filed against him, and made just five annual inspections, most satisfactory, since the clinic opened in 1979, authorities said. The inspections stopped completely in 1993 because of what prosecutors said was the pro-abortion rights attitude that set in after Democratic Gov. Robert Casey, an abortion foe, left office.
Williams accused state Health Department officials of "utter disregard" for the safety of women undergoing abortion, and said the testimony of agency officials "enraged" the grand jury. But he said he could find no criminal offenses with which they could be charged, in part because too much time has elapsed.
"These officials were far more protective of themselves when they testified before the grand jury. Even (Health Department) lawyers, including the chief counsel, brought private attorneys with them - presumably at government expense," the report said.
The state's reluctance to investigate, under several administrations, may stem partly from the sensitivity of the abortion debate, Williams said. Nonetheless, he called Gosnell's conduct a clear case of murder.
"A doctor who with scissors cuts into the necks, severing the spinal cords of living, breathing babies who would survive with proper medical attention commits murder under the law," he said. "Regardless of one's feelings about abortion, whatever one's beliefs, that is the law."
Four clinic employees were also charged with murder, and five more, including Gosnell's wife, Pearl, with conspiracy, drug and other crimes. All were in custody. Gosnell's wife performed extremely late-term abortions on Sundays, the report said.
One of the murder charges against Gosnell involves a woman seeking an abortion, Karnamaya Mongar, who authorities said died in 2009 because she was given too much of the painkiller Demerol and other drugs.
Gosnell wasn't at the clinic at the time. His staff administered the drugs repeatedly as they waited for him to arrive at night, as was his custom, the grand jury found.
Mongar and her husband, Ash, had fled their native Bhutan and spent nearly 20 years in camps in Nepal. They had three children. A man who answered the phone Wednesday at a listing for Ash Mongar in Virginia did not speak English, while their daughter did not immediately return a message.
Bernard Smalley who represents the family of Mongar spoke to Action News Wednesday night.
"His actions and inactions were outrageous. They were reckless," Smalley said. "When he was in trouble, and he knew that she was not breathing, she was pulseless, there was no equipment on the premises to resuscitate her."
The malpractice suits filed against Gosnell include one over the death of a 22-year-old Philadelphia woman, a mother of two, who died of a bloodstream infection and a perforated uterus in 2000. Gosnell sometimes sewed up such injuries without telling the women about the complications, prosecutors said.
Gosnell earned his medical degree from Thomas Jefferson University in Philadelphia and is board certified in family practice. He started, but did not finish, a residency in obstetrics-gynecology, authorities said.
Assistant District Attorney Joanne Pescatore said: "He does not know how to do an abortion. Once he got them there, he saw dollar signs and did abortions that other people wouldn't do."
Full list of charges from the DA:
D.A. Williams provided a list of charges against all of the defendants in a news release. The list reads as follows:
Gosnell is facing Murder in the 3rd Degree for the death of 41-year-old Karnamaya Mongar. Mrs. Mongar died on November 20, 2009 when she was allegedly overdosed with anesthetics prescribed by Gosnell. He is also facing seven Murder charges for the deaths of infants who were killed after being born viable and alive during the 6th, 7th and 8th month of pregnancy. Along with the Murder charges the District Attorney has charged Gosnell with Infanticide, Conspiracy, Abortion at 24 or more weeks, Abuse of Corpse, Theft, Corruption of Minors, Solicitation and other related offenses.
42-year-old Lynda Williams of N. Madison Avenue in Wilmington, Delaware is also facing Murder in the 3rd Degree for the death of Ms. Mongar. Williams was an unlicensed worker at the clinic who routinely performed illegal operations and administered anesthesia. She is also facing Murder charges for the death of a viable baby born alive, Abortion at 24 or more weeks, Conspiracy, Racketeering and other related offenses.
51-year-old Sherry West of the 1800 block of Blatty Place in Newark, Delaware is also facing Murder in the 3rd Degree for the death of Ms. Mongar. West was an unlicensed worker at the clinic who routinely performed illegal operations and administered anesthesia. She is also facing Abortion at 24 or more weeks, Conspiracy, Racketeering, Tampering with records, Hindering Prosecution, Obstructing Administration of Law and other related offenses.
33-year-old Adrienne Moton of Hampton Road in Upper Darby, Pa. is facing a Murder charge for the death of a viable baby born alive. Moton who was an unlicensed worker at the clinic, routinely and illegally administered anesthesia to patients, the DA said. She is also facing Conspiracy and Racketeering charges.
48-year-old Steven Massof of W. Marlin Drive in Pittsburgh, Pa. is facing Murder charges for the deaths of two viable babies born alive. Massof, a medical school graduate without a license or any certification, worked as a doctor at the clinic. He is also facing Conspiracy, Theft by Deception, Racketeering and other related charges.
51-year-old Elizabeth Hampton of the 5000 block of Arch Street in Philadelphia, Dr. Gosnell's sister-in-law, is facing Obstructing Administration of Law, Hindering Prosecution, Perjury, and False Swearing charges.
54-year-old Eileen O'Neill of Nutt Road in Phoenixville, Pa is a medical school graduate who worked as doctor at the clinic without a license or certification. She is facing Theft by Deception, Conspiracy, Racketeering, Perjury and False Swearing charges.
45-year-old Tina Baldwin of S. 63rd Street in Philadelphia is facing Racketeering, Conspiracy, and Corruption of a Minor Charges. Baldwin was an unlicensed worker at the clinic who not only illegally administered anesthesia to patients, the DA said she allowed her 15 year old teenaged daughter, who also worked at the clinic, to administer anesthesia to patients as well.
49-year-old Pearl Gosnell of N. 32nd Street in Philadelphia is facing Abortion at 24 or more weeks, Conspiracy and other related charges. Gosnell, the wife of Kermit Gosnell who has no medical license, is accused of performing illegal abortions at the clinic.
53-year-old Maddline Joe of the 800 block of Atwood Road in Philadelphia is facing a Conspiracy charge. She was the office manager at the clinic in West Philadelphia.