Virginia health officials are poised to approve strict new rules for abortion clinics Friday amid massive opposition from pro-choice groups and a governor's race with two candidates closely tied to the opposing sides.

Under the new guidelines, clinics would be required to meet the same building codes as hospitals, including bigger parking lots, wider hallways and larger operating rooms. Opponents of the measure say the changes would be burdensome and costly and could force many of the state's 23 providers to close their doors.

The state Board of Health vote on Friday follows two years of contentious debate that included significant pressure from Attorney General and Republican gubernatorial candidate Ken Cuccinelli, who favored a more aggressive crackdown on abortion clinics.

Last year, Cuccinelli refused to certify an agreement between health officials to exempt existing clinics from the tougher rules, and he threatened not to represent the board in any legal challenges if it ignored his concerns. Health officials agreed to rewrite the rules so they applied to existing clinics, prompting Health Commissioner Dr. Karen Remley to resign in protest.

"The attorney general's primary duty is to certify whether the regulations adopted by the Board of Health comply with Virginia law, which is exactly what he intends to do," Cuccinelli spokeswoman Caroline Gibson said.

Democratic gubernatorial candidate Terry McAuliffe said Friday's vote is a reminder of Cuccinelli's conservative anti-abortion position.

"Despite weeks of criticism for comparing his own effort to outlaw all abortion to slavery abolitionists, Cuccinelli is continuing to pursue an agenda that is far outside the Virginia mainstream," McAuliffe spokesman Josh Schwerin said.

Proponents of the new rules say they are needed to ensure the safety and health of women. To underscore the need, the Family Foundation of Virginia, an anti-abortion group, on Thursday released inspection reports from existing clinics that found dried blood on equipment, underage patients without parental consent and hygiene issues.

"[Clinics] don't want to be held accountable to the Virginia Board of Health or public health officials," said Family Foundation President Victoria Cobb. "They want to continue to operate as they have for more than two decades -- with bloody equipment and inadequate, untrained staff."

President Obama won 54 percent of women's votes in Virginia last year in part by attacking Republicans as anti-woman because of their opposition to abortion and birth control. Abortion-rights groups, who plan a protest at the Health Board's meeting Friday, say they will try a similar strategy and use the vote against Cuccinelli in the campaign.

Democrats tried to use women's issues to paint Republican Gov. Bob McDonnell as an extremist in the 2009 gubernatorial race, but McDonnell thwarted the effort by keeping voters focused on jobs and the economy instead of divisive social issues.

"McDonnell had tried to play down a lot of his conservative views, and I think Ken Cuccinelli has been very forthcoming about what his agenda is," said Caroline O'Shea, deputy directory of NARAL Pro-Choice Virginia. "He's talking about going to jail to oppose birth control. He has not been subtle, and there's going to be no way to hide from it."