This article is cross-posted with permission from Alternet.

Dr. Kermit Gosnell has been charged with murdering one woman and seven newborn babies at his rogue clinic, called the Women’s Medical Society, in West Philadelphia. Though it’s too early to predict this case’s full political impact, it’s certain that anti-abortion groups will use it to push for further restrictions on women’s reproductive rights. But the legislation pushed by these anti-abortion conservatives is what has forced women into such life-threatening situations. Poor women throughout the United States cannot afford safe abortions and in consequence sometimes make extremely dangerous choices.

“Because of the Medicaid ban on abortion funding and state restrictions, poor women in the state and in Philadelphia really face horrific choices about what to do if they have an unwanted or unplanned pregnancy, or a pregnancy that poses significant health problems,” says Rose Corrigan, a professor of politics and law at Drexel University. “So what I’ve seen is that women often shop around for abortion services. Women are so poor that a few dollars really make a difference.”

Corrigan is also a volunteer at the Women’s Medical Fund, a Philadelphia organization that offers financial assistance to poor women seeking abortions. She says that her organization has been advising women against visiting the Women’s Medical Society since the mid-1990s.

“When women would call us we’d say, ‘There’s a reason it’s cheap. Don’t go there.’”

“I think it’s also that abortion has become so stigmatized and that abortion care has become so ghettoized from mainstream medical care,” says Susan Schewel, executive director of the Women’s Medical Fund. “It means that people aren’t talking about where’s a good place to go and where’s a safe place to go. And when women are harmed they’re afraid to go the authorities. We’ve talked with people here who have been mistreated at this clinic. And we’ve asked them to report it to proper state government authorities, and they said, ‘No way would we do that.’”

Some women did complain and the grand jury report faults the State of Pennsylvania for a catastrophic failure of oversight. Law enforcement officials in Philadelphia only became aware of the clinic in the course of an unrelated investigation into allegations that Dr. Gosnell was illegally distributing narcotics like Oxycontin.

“The grand jury investigation revealed,” according to a press release from District Attorney Seth Williams, “that, for over two decades, government health and licensing officials had received repeated reports about Gosnell’s dangerous practices. No action was ever taken, however, even after the agencies learned that women had died during routine abortions under Gosnell’s care.”

“Many organizations that perform safe abortion procedures do their own monitoring and adhere to strict, self-imposed standards of quality,” according to the grand jury report. “But the excellent safety records and the quality of care that these independently monitored clinics deliver to patients are no thanks to the Pennsylvania Department of Health. And not all women seeking abortion find their way to these high-quality facilities; some end up in a filthy, dangerous clinic such as Gosnell’s.”

The Women’s Medical Society, which opened in 1979, largely treated poor women of color. Dr. Gosnell, who was not certified as an ob/gyn, is charged with the murders of 41-year-old Nepali refugee Karnamaya Mongar and seven infants, and a number of other violations. Nine other clinic employees face murder and other charges. According to the grand jury report, Dr. Gosnell provided more attentive care in cleaner rooms to white women from the suburbs.

“I think that the failure of the state, when there have been these complaints for years, speaks to the way abortion isn’t considered normal health care, that abortion is segregated off from regular health care,” says Corrigan. “I really don’t think that if these complaints were coming in about another doctor the state would have ignored it. I really think it’s also about women being punished for having an abortion.”

Many patients would visit Dr. Gosnell for late second-trimester and illegal third-trimester abortions. Limited access and information can delay women seeking an abortion.

“In our experience,” says Schewel, “we find a lot of women do what we call chasing the fee,” where poor women try to raise money for an abortion that gets more and more expensive as the pregnancy progresses. She says that stigma and misinformation also delay the procedure.

“The huge majority of abortions in this country are done in the first trimester, even first eight weeks, of pregnancy. Again, it’s about access: people not knowing where to go, that they even can get an abortion. To me what’s most striking is that throughout the globe and throughout history, women will do whatever it takes to end a pregnancy that they don’t want to carry to term. And this is an example. Whether abortion is legal or illegal, whether it’s accessible or not accessible, women who need to end a pregnancy will do whatever they need to do.”

The Hyde Amendment bars the spending of federal Medicaid dollars on abortions. States like New York fund abortion services with state Medicaid dollars. But Pennsylvania, like 26 other states, does not. NARAP Pro-Choice America gave Pennsylvania an F grade for reproductive rights, ranking it 41st out of 50.

According to a 2006 study by the Women’s Medical Fund, there were 4,500 women covered by Medicaid in the five-county Philadelphia area who wanted to terminate a pregnancy and could not afford to. Making things all the more difficult, most health-care providers do not perform abortions.

“If doctors felt more comfortable performing abortions in private offices,” says Corrigan, “if more hospitals provided abortion, if there wasn’t such a stigma around abortion, we wouldn’t see women dying.”

There is a two-tier reproductive health system in the United States, and even pro-choice politicians seem loath to upset the status quo. Rural women throughout the country lack access to abortion clinics, including women in 82 percent of Pennsylvania counties. But even in cities like Philadelphia, home to a number of clinics, cost can be an insurmountable obstacle.

”Pro-choice politicians want to talk about keeping abortion legal but don’t want to talk about restoring federal funding for abortion,” says Corrigan. “That’s part of this tragedy: we’re willing to let women die as long as our suburban mothers and daughters can get an abortion.”

Political opponents of abortion are already making use of the Philadelphia story to campaign for tighter restrictions on abortion.

In recent years, anti-abortion activists have cited the high rates of abortion among black women, calling abortion a form of “genocide” against the community. There is no small degree of irony–and cynicism–in the conservative campaign given the right’s history of blaming young and poor welfare recipients for their fertility.

And in states throughout the country, conservatives have been chipping away at reproductive rights through legislation requiring ultrasounds prior to abortions or laws recognizing “fetal pain.” On the national level, many advocates accuse Democrats of lessening their commitment to abortion rights. In many ways, policies on abortion rights have been heading in reverse.

“This was like a pre-Roe v. Wade clinic,” Schewel says. “And I think that as abortion access becomes narrower and narrower and more and more limited, there will be more and more of these types of providers.”