Dr. Kermit Gosnell, 70, ran a filthy West Philadelphia medical practice that served as a pill mill by day and an abortion mill by night, a grand jury concluded in January after a two-year investigation.
The multiple deaths and tender age of the babies - allegedly killed with scissors after being born alive - are the aggravating circumstances that warrant the death penalty for Gosnell, Assistant District Attorney Joanne Pescatore said Wednesday.
Defense lawyers have suggested that Gosnell, his wife and eight other defendants who worked at the neighborhood clinic treated poor women and minorities when no one else would.
Gosnell's lawyer said his client would die of old age before a death sentence would ever be carried out.
"Dr. Gosnell is never going to get the death penalty," lawyer Jack McMahon said after a brief court hearing. "You have a 70-year-old man, and it makes the case three times as long and as costly."
Gosnell is being held without bail on eight counts of murder, and was not brought to court for the formal arraignment. His next hearing is set for March 30.
Gosnell made millions over the years from the clinic, and with his wife owns numerous properties, prosecutors say. A judge in a civil suit has frozen his assets to protect the family of Karnamaya Mongar, a 41-year-old refugee who died after allegedly receiving lethal doses of sedatives and painkillers at the clinic in 2009.
A second woman also died from a botched abortion, while scores more suffered perforated bowels, cervixes and uteruses, authorities said.
Gosnell was once board certified in family practice, but had long ago let his certification lapse, authorities said.
State health officials, perhaps mired in the incendiary politics of the abortion debate, failed to inspect the clinic from 1993 until a 2009 federal raid sparked by his prescription drug-writing practices.
They found fetal remains stored in refrigerators amid staff lunches, along with other unsanitary and barbaric conditions.
At a legislative hearing Wednesday in Harrisburg, Gov. Tom Corbett's top public health adviser pledged more aggressive oversight of abortion providers. Several health officials cited in the grand jury report have since been fired or demoted.
Dr. Eli Avila, Corbett's nominee to head the state Department of Health, vowed to implement unannounced inspections, a battery of training and an online complaint system, among other measures.
The department's inspectors, registered nurses who already inspect hospitals and surgery centers, will be trained to inspect abortion clinics, and abortion providers will be required to attend training in Harrisburg on the state's rules and regulations, Avila said.
"The department has instituted measures to ensure that such a public health breakdown does not occur again in our commonwealth," Avila testified at the joint House-Senate committee hearing.
Philadelphia prosecutors charge that Gosnell's staff - including his cosmetologist wife, two unlicensed medical school graduates and a high school student - administered drugs and otherwise helped perform illegal, late-term abortions.
Prosecutors are still weighing the death penalty for three others charged with a single count of murder.
Pearl Gosnell, the doctor's wife, is not among them, but she remains jailed on $1 million bail for allegedly performing illegal, third-trimester abortions and participating in a corrupt organization.
"She's a pawn in the prosecution of her husband," defense lawyer Mary Maran told The Associated Press. "The grand jury report and the discovery say absolutely nothing about what Pearl knew about the age of the babies. She's not a doctor."
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.
Associated Press Writer Marc Levy in Harrisburg contributed to this report.