Did Dr. Charles Momah, a South King County obstetrician/gynecologist, use his role as a doctor to sexually abuse his patients, controlling them with his prescription pad and silencing them with warnings that they would never be believed?

Or was he a caring, concerned doctor, one of a dwindling number of specialists willing to treat women on state-funded medical insurance, a man who went the extra mile to protect patients' ability to have children and ease their pain?

A King County Superior Court jury in Seattle this morning heard both those arguments as Momah went on trial on criminal charges of rape and indecent liberties involving four female patients. If convicted on all charges, Momah could be sentenced to as many as 16 years behind bars.

"He was willing to use his power and position to exploit the vulnerabilities [of] these women," says deputy prosecutor Scott Fogg.

Counters Momah's lawyer, David Allen of Seattle: "Dr. Momah is a very highly qualified professional individual. He has never sexually touched any of his patients during any procedures."

Momah, 49, ran clinics in Federal Way and Burien until September 2003, when authorities suspended his license.

A year later, prosecutors charged Momah with one count of second-degree rape, one count of third-degree rape and two counts of indecent liberties. He was also charged separately with three counts of health-care fraud, which will be tried later.

Momah also faces a string of civil suits that will be handled as separate cases after the criminal trial.

On the sex charges, prosecutors say they have DNA evidence that Momah raped one of the women, and they plan to present testimony from her and the other three women Momah is charged with abusing.

Earlier this month, Judge Michael Trickey ruled that prosecutors also will be allowed to present the testimony of three former patients who accuse Momah of sexual abuse but are not officially victims in the criminal charges currently leveled against him. The goal is to show that Momah's attacks were not isolated incidents.

But Trickey rejected the prosecutors' request to call many other women to accuse Momah of lascivious behavior. In all, at least 50 women, through civil suits or statements to police and state licensing authorities, have accused Momah of various sexual or ethical violations.

"He's someone who abused the trust that was essentially hand-delivered to him," Fogg said. "One of the things we'll focus on is that he was certainly aware of his position."

Momah knew, for example, that as a doctor he would be more likely to be believed than a patient who was addicted to drugs or on medical assistance, Fogg alleges.

"He was aware of the position and the power he held, and the vulnerability of some of these women," Fogg said.

The attacks came to light only because one woman was brave enough to go straight from Momah's office to a hospital for a "rape kit," used to preserve physical evidence, Fogg says.

"When she came forward, she provided the light for all these women to say, 'I'm not alone.' " Fogg said. "They all moved forward because of her."

Momah's attorney will argue that, among other things, the women falsely accusing Momah are motivated by money. Allen says they all talked with the same local civil attorney, and three of the four have sued Momah. "To me, that says something awfully strong," Allen said.

He plans to show the jury that Momah was one of only a few local gynecologists willing to see patients on welfare. He specialized in helping women who wanted to get pregnant, often attempting to reverse sterilizations or correct other medical problems, Allen said.

"He really worked very hard for his patients," Allen said.

Allen said he plans to give the jury some background about Momah: A native of Nigeria, he graduated from medical school there, received more training in Montreal, and was board-certified by the Royal College of Surgeons of Canada in 1989. After practicing in New York, Momah was licensed in Washington in 1993.

The trial is expected to last six weeks.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com