Kermit Gosnell has been found guilty of the very savagery that legalized abortion was supposed to end. His murder conviction Monday should leave both sides of the sanctity-of-life debate asking how he got away with it for so long.

Gosnell had been performing abortions at his Women's Medical Society clinic in West Philadelphia for 30 years before a 2010 drug raid there revealed fetuses stuffed into bags, milk jugs, and juice cartons. The state subsequently shut down the clinic, and a grand jury accused Gosnell of running a house of horrors.

Reeking of cat urine and lacking trained staff, Gosnell's bloodstained clinic was an affront to one of the chief arguments for legal abortion: that it would prevent women from being mutilated, maimed, and murdered by unscrupulous doctors and others who would terminate any pregnancy for a fee.

The term "back-alley abortion" became common decades ago, when so many of the then-illegal procedures were taking place not in medical settings, but amid unsanitary conditions in homes or offices that women visited secretly. By some estimates, up to 200,000 such illicit procedures were performed each year in this country between 1880 and 1973, when the Supreme Court's Roe v. Wade decision found statutes arbitrarily outlawing abortion to be unconstitutional. Before Roe, the wire clothes hanger became a disturbing emblem of abortion, a reminder that a piece of twisted metal might be used to perform a procedure that, because it was illegal, was also unregulated.

Making abortion legal and putting it under government's watchful eye was supposed to keep people like Gosnell from practicing butchery. But the jury found that Gosnell, 72, killed three babies after they were born alive, and it found him guilty of involuntary manslaughter in the death of a woman who died of a drug overdose at his clinic. He was also found guilty of many of the lesser charges against him, which included performing abortions after 24 weeks of gestation, the limit set by Pennsylvania law, and routinely ignoring the 24-hour waiting period required before an abortion is performed.

Antiabortion activists have argued that the Gosnell case is the latest evidence that the practice of abortion is beyond redemption and should end - period. But the bad doctor's atrocities serve just as much as a clarion call for better scrutiny of all abortion providers.

It's unlikely that Gosnell's horror show could have gone on for so long if his patients hadn't been poor women who couldn't afford to go elsewhere - and who didn't want to draw attention to themselves by reporting what they had seen and experienced inside his den of depravity.

Pennsylvania already has some of the nation's strictest abortion-clinic regulations. In fact, five clinics closed after more stringent rules were imposed in 2011. But such rules are meaningless unless they're enforced.

That's the strongest message of the Gosnell case: that no procedure that determines life and death should be treated as so routine that it can be ignored.