A Cuyahoga County grand jury returned the indictment Friday against Ariel Castro, a former school bus driver fired last fall.
Castro, 52, is accused of kidnapping Amanda Berry, Gina DeJesus and Michelle Knight and holding them captive along with a 6-year-old girl he fathered with Berry.
The grand jury charged Castro with two counts of aggravated murder related to one act, saying he purposely caused the unlawful termination of a pregnancy. Castro also was indicted on 139 counts of rape, 177 counts of kidnapping, seven counts of gross sexual imposition, three counts of felonious assault and one count of possession of criminal tools.
Castro's attorneys have said he would plead not guilty to any indictment. Castro, during his brief arraignment last month, tried to hide his face, tucking his chin inside his shirt collar and did not speak.
Castro is being held on $8 million bail. He has been taken off suicide prevention watch, jail officials said this week.
He was arrested May 6, shortly after Berry broke through a locked door, yelled to neighbors for help and escaped with DeJesus and Knight.
Berry, 27, told officers that she was forced to give birth in a plastic pool in the house so it would be easier to clean up. Berry said she, her baby and the two other women had never been to a doctor during their captivity.
Knight, 32, said her five pregnancies ended after Castro starved her for at least two weeks and "repeatedly punched her in the stomach until she miscarried," authorities said.
She also said Castro forced her to deliver Berry's baby under threat of death if the baby died. Knight said that when the newborn stopped breathing, she revived her through mouth-to-mouth resuscitation.
The women had vanished separately between 2002 and 2004, when they 14, 16 and 20 years old. They haven't spoken publicly since their ordeal.
Castro's two brothers were arrested with him but later were cleared of involvement in the case and were released.
The Associated Press does not usually identify people who may be victims of sexual assault, but the names of the women were widely circulated by their families, friends and law enforcement authorities for years during their disappearances and after they were found.