HARRISBURG - For two decades, the word abortion had all but vanished from debate in the Capitol.

Abortion-rights advocates and longtime legislative aides are hard-pressed to think of a single significant vote on an abortion bill in 20 years, stretching back to Planned Parenthood v. Casey, the landmark Pennsylvania case that became the first major challenge to Roe v. Wade.

All that changed this year.

Despite a looming budget deadline and a host of pressing fiscal issues ranging from Marcellus Shale tax proposals to the slashing of aid for schools, abortion bills have been fast-tracked in an otherwise slow-moving legislature. In the last month, three votes have been taken on abortion-related proposals. A fourth is expected this week.

The push has abortion-rights advocates warning that the effort is part of an orchestrated attack on legalized abortion in statehouses across the country.

"Forget the state budget, forget creating jobs and stimulating the economy - abortion is the priority now," said Andy Hoover, legislative director of the American Civil Liberties Union of Pennsylvania. "I can't remember the last time we've seen anything like this."

But then, no one can remember a horror story like the Gosnell clinic.

The news that Kermit Gosnell, who ran a West Philadelphia clinic for 30 years, had been charged in the deaths of seven babies killed with scissors and a woman in a botched abortion stunned the newly elected Gov. Corbett and legislators, who vowed to ensure that such alleged atrocities would never be repeated.

Revelations that no state inspections had been conducted at the clinic in 17 years prompted legislators to begin crafting bills to address what they saw as shortcomings in the regulatory and inspection process.

"This is about women's health," said Sen. Bob Mensch (R., Montgomery), architect of an amendment calling for stricter regulation of clinics. "To say that it's anything but that just isn't true."

The proposals coincide with a wave of restrictive abortion bills moving through statehouses across the country - especially those which, like Pennsylvania's, have new Republican majorities.

Elizabeth Nash, a public policy associate at the Guttmacher Institute, a think tank that studies reproductive-health issues, said legislatures were taking aim at abortion in ways unseen since Roe. This year, she said, 70 abortion restrictions have been enacted, far exceeding the 34 approved in 2005, the second-highest number.

The debate in Harrisburg has gotten both sides' attention.

"What we feared would happen did," said Dayle Steinberg, president of Southeastern Pennsylvania Planned Parenthood. "Those who oppose abortion have given up on Roe, so they whittle away at freedoms granted under Roe by taking it to the states."

The conservative Pennsylvania Family Institute has sent "action alerts" by e-mail to rally its supporters behind Mensch's bill. The group's president, Michael Geer, dismissed the other side's contention that the bill was a ruse.

"We care about all life," Geer said in an interview. "We don't want the women going in to be harmed, even if one life is definitely at risk."

In Pennsylvania's General Assembly, at least three abortion-related bills are pending. One, championed by Rep. Matt Baker (R., Bradford), would have the law treat the state's 20 "freestanding" abortion clinics - those not connected to hospitals - as "ambulatory surgical facilities," subjecting them to stricter inspections and operating regulations.

Baker drafted his bill in response to the Philadelphia grand jury's grisly report on Gosnell's clinic. Jurors repeatedly asked why state health officials did not hold abortion clinics to the same standards as "ambulatory surgical facilities" - outpatient clinics that are licensed to perform eye, foot, and other operations.

The state subjects those clinics to annual inspection and unannounced visits to investigate complaints. They also must have larger rooms, wider, hospital-grade elevators, and a registered nurse on the premises at all times.

Why do some of those regulations seem onerous to abortion-rights advocates? Jennifer Boulanger, executive director of the Allentown Women's Center, pointed to her counterparts at the Philadelphia Women's Center. A seventh-floor tenant in a downtown office building, that clinic would be hard-pressed to expand its space or retrofit its elevators.

Boulanger, among others, contends that Baker's bill would backfire - clinics would be forced to close, leading to more "illegal abortions, more Gosnells, and women who self-abort."

Abortion-rights advocates argue that current laws fully regulate abortion clinics and require regular inspections. They contend that all it takes to prevent the next Gosnell is strict enforcement of those laws.

But why were those laws not being enforced?

The grand jury suggested the politics of abortion caused inspectors to turn a blind eye to clinics such as Gosnell's.

"Pennsylvania's laws are stringent, and the Gosnell situation, as tragic as it was, was a failure of government, not a failure of law," the ACLU's Hoover argued.

He and other abortion-rights advocates contend that the Baker bill in the state House, and a similar one in the Senate, would force clinics to close by requiring them to make costly structural changes and increase staffing.

In the middle of this fight is a midstate Republican who supports abortion rights, wants tougher clinic standards, and is the only registered nurse among Pennsylvania's 253 legislators. Sen. Pat Vance (R., Cumberland) crafted a bill that would increase regulations and inspections but not require costly overhaul of medical facilities.

On Wednesday, her bill came under fire - from a fellow Republican, Mensch.

He offered an amendment that would require clinics that perform abortions after the ninth week of pregnancy to comply with ambulatory facility requirements. The floor debate lasted more than an hour.

Vance and Democrats fought to preserve her bill from what they viewed as a hostile takeover by Mensch. She called his amendment "a cover for those who do not like abortion."

They lost by a vote of 31-18. It became Mensch's bill.

Mensch said he had seen no evidence that making abortion clinics follow "ambulatory" clinic requirements would force them to close. "I've asked them to show me the evidence, but I haven't seen it," he said. (Planned Parenthood's Steinberg said a similar law had reduced abortion clinics in Texas from 20 to two.)

A final vote on Vance's legislation - with the Mensch amendment - is expected next week.

Meanwhile, the other chamber was addressing insurance coverage of abortions. The state Senate last week passed a bill to ban such coverage by policies obtained through the health-insurance exchanges that are to begin in 2014 under the federal health-care law. Under that law, states are to set up the exchanges - essentially insurance marketplaces - to enable small businesses and individuals to buy coverage.

Sen. Don White (R., Armstrong) argued that tax money is required to set up and regulate the exchanges, making the sale of insurance policies that cover abortions tantamount to taxpayer funding of abortions.

His argument echoed those in Congress two months ago, when some Republicans held up the federal budget over funding for Planned Parenthood.

Eight states have adopted measures similar to White's, according to the Guttmacher Institute's Nash.

She said the recent ascendance of conservative Republicans in Congress and state legislatures - along with specific episodes such as the Gosnell case - had pushed abortion to the front burner.

"What happened in the Gosnell case was tragic," Nash said. "But this person should not be associated with abortion providers in general."

Mensch countered: "Please, let's not make this into a pro-life, pro-abortion issue. Let's make this about the health and safety of women. Because that's what it should be about."