New York socialite Madeline West Reeves arrived in Port Charles to visit her son-in-law Silas Clay. Silas had been accused of injecting his wife Nina Reeves with an overdose of a prescription which had led to Nina being comatose for twenty years. Madeline vowed to make Silas pay for harming her daughter, and she worked closely with Detective Nathan West to seek justice. According to Madeline, Silas' motive for the attempted murder had been greed, and he had wanted an open relationship with his mistress, Ava Jerome.

On March 14, 2014, Madeline paid her son a visit. Detective Nathan West was revealed to be James Nathan Reeves, Nina's younger brother. He had used his middle name and his mother's maiden name to hide his connection to the wealthy Reeves family, so that he could gather evidence to charge Silas. Nathan had located the pharmacist that had filled the prescription that had been used to put Nina in a coma. Before Nathan could question the man, the pharmacist had been found murdered.

On March 26, Madeline revealed that Nina had passed away weeks earlier from pneumonia. Nathan was more determined than ever to solve his sister's murder, and he began to suspect that perhaps Ava might have taken it upon herself to remove the competition for her lover's attention. Nathan set a trap for Ava, but it was Madeline who had walked into it. Madeline confessed that she had killed the pharmacist, and she had injected Nina with an overdose of antidepressants because she had hoped to trigger Nina to miscarry Silas' child.

On April 7, 2014, Madeline was arrested and placed in a cell across from Liesl Obrecht. In a shocking twist, Liesl was revealed to be Madeline's younger sister. The women had grown up in Zurich, Switzerland, and Madeline had been known as Magda Westbourne. Madeline had changed her name when she had fled legal troubles in Europe and reinvented herself in New York. The sisters exchanged barbs and taunted one another until Nathan paid Madeline a visit. After he left, Liesl realized that she had just seen the son that she had asked Madeline to raise.

Madeline warned Liesl not to reveal the truth to Nathan, but Liesl was intent on a reunion with her progeny because she was certain that her daughter Britt would be thrilled to meet a sibling. Although Madeline had planned to keep the secret from Nathan, things changed when Nathan mentioned spending the night with a woman whose mother had been a bad as Madeline. Madeline was shocked when she realized that he had been referring to Britt Westbourne. Nathan and Britt hadn't been intimate, but Madeline blurted out that Britt was his sister then revealed that Liesl was Nathan's biological mother. Shocked, Nathan pulled away from Madeline.

Madeline reached out to Nathan, but he couldn't forgive her for the lies she had told, and what she had done to Nina. On May 1, Madeline confided that she had lied -- Nina was alive. Madeline explained that she had lied because she'd been destitute, and she had needed access to Nina's inheritance. Nathan was unmoved, and Madeline was transferred to Riker's Island to await trial.

Meanwhile, Nina had emerged from the coma, and she was furious that she'd been robbed of twenty years of her life and her unborn child. Adding to Nina's pain was the knowledge that Silas had had a daughter with his mistress, and he'd found love with another woman named Sam McCall. Nina's dreams of having a child of her own were shattered in August when her cousin Britt revealed that Nina's coma had put her into menopause long ago. Adding salt to Nina's wound was the discovery that Ava was pregnant with a second child.

On October 14, Madeline returned to Port Charles claiming that she wanted to make amends. She explained that her legal team had gotten all of the charges against her dropped, and that she was once again destitute because Nina had taken control of the money. And she had cut Madeline out. Nathan didn't believe Madeline, but she warned him that there was a side to his sister that he didn't know.

Later, Madeline had an encounter with Nina when Nina stopped by Nathan's apartment to talk to her brother. Nina was furious that her mother had been freed, and she angrily demanded that Madeline "repent." Nina's erratic moods continued to shift between anger, sadness, and disbelief as she confronted Madeline about the coma and miscarriage. Madeline worried that Nina might not be on the proper medication, and she cautioned Nina not to do anything that Nina might regret.

Madeline was right to be concerned. Nina had hatched a diabolical plan to steal Ava's unborn child -- and she expected Madeline to help in exchange for a substantial share of Nina's inheritance.

On October 27, Nina decided that she couldn't wait for Ava to go into labor, so Nina and Madeline made plans to induce Ava's labor. On Halloween, armed with two vials of medication, Nina slipped into the brownstone where Ava had been staying. After Nina injected a very pregnant Ava with a paralytic that would slowly render Ava unable to move, Nina explained that Ava would still be able to breathe and feel everything. Next, Nina injected Ava with a drug to induce labor. Moments after Ava gave birth to a daughter, Madeline helped Nina escape with the newborn.

On November 7, while Nina, Madeline, and the baby were in hiding, Nina confronted her mother about something that Ava had revealed. Nina wanted to know if it was true that Madeline had paid Ava twenty years earlier to seduce Silas away from Nina. Madeline admitted that it was true, but she pointed out that Silas could not have been seduced if he had truly loved Nina. Things quickly deteriorated at the Rendezvous motel as Nina's grasp on reality began to slip. Madeline tried her best to keep Nina calm, but Nina's temper flared when she realized that her mother hadn't called Silas as Nina had requested. Nina picked up a lamp and struck her mother with it.

A short time later, the police kicked in the door and found Madeline unconscious on the floor. Nina and the baby were gone. Madeline was taken to the hospital. When she woke up, she found herself handcuffed to the bed. Nathan explained that she was in police custody for helping Nina, but Madeline insisted that she hadn't had any choice; Nina had been unhinged. Madeline claimed that not only had she been hurt, but she had also tried to alert the police by leaving her sister a voicemail message about where she and Nina had been hiding. Madeline was adamant that she would have been killed if she hadn't helped Nina.

Madeline credited Franco with saving her life because he had stopped Nina from attacking Madeline further. After Nathan had left the hospital room, Liesl confronted Madeline about her lies. Liesl knew that Madeline had kept Nina in the motel, and that she had pretended to leave a message for Silas on Liesl's voicemail, because Madeline had hoped to find a way to trick Nina into signing over Nina's fortune. Madeline refused to be intimidated because she was certain that Liesl had been the one to tip off Franco to Nina's whereabouts.

A few days later, Madeline had recovered. As she was being transferred to Pentonville, Nathan mentioned that he had learned that his father was Victor Cassadine. Stunned, Madeline called her sister. Madeline threatened to tell Nathan the truth about who his real father was if Liesl didn't testify on Madeline's behalf.

In January 2015, Madeline became an unwitting conspirator in a prison escape when Sonny Corinthos and several others used the transport van that had been sent to retrieve Madeline for an escape. Despite not leaving Pentonville grounds, Madeline was charged with attempting to escape.

In June 2015, Madeline was waiting to be paroled, but she had hatched a plan with attorney Ric Lansing to get her hands on Nina's money. Unfortunately for Madeline, Ric had outmaneuvered Madeline by seducing and marrying Nina. As soon as Madeline was released from jail, she made her way to Ric and Nina's hotel room to have a chat with her new son-in-law. The encounter ended with the Ric and Madeline in bed.

On July 31, 2015, Silas Clay was murdered. Nina had been found kneeling over his body clutching the bloody murder weapon -- a knife that had been plunged into his back -- but Franco had confessed to the crime. However, on August 31, Ric Lansing double-crossed Madeline by tricking her into confessing that she had murdered Silas Clay. Later, Madeline tried to blame the murder on Ric, but her fate had been sealed with a forged legal document that had put her at the scene of the crime.

Madeline was convicted for Silas' murder and sent to Pentonville. On August 17, 2018, Maxie and Nina paid Madeline a visit to share pictures and videos of Nathan's young son, James. Madeline was delighted to see a glimpse of the young boy that she considered a grandson, especially since Nathan had passed away. Nina thought that it was fitting that Madeline felt the pain of not knowing James because Madeline had taken away Nina's only child. Madeline saw the pain in her daughter's eyes.

Madeline conceded that she had let her greed cloud her judgment, but she promised her daughter that she had changed. Madeline admitted that her cellmate had shown her a video of Valentin Cassadine serenading Nina, and Madeline hoped that Nina had finally found the love that Nina had deserved. Madeline continued that she had joined therapy groups in prison, and she had become a model prisoner, so she was hopeful that she would be granted parole. Nina angrily accused her mother of trying to manipulate Nina and Maxie into testifying for Madeline at the hearing. Nina and Maxie vowed that they were through with Madeline.

After Nina and Maxie left, Valentin paid Madeline a visit. He wanted information from Madeline in exchange for putting her in touch with Llanview attorney Nora Buchanan. He promised that Nora could help with Madeline's parole hearing. Valentin had noticed that Nina's medical records had been sorely lacking information, which he suspected meant that Nina's baby had survived. Madeline denied it, but Valentin reminded her what was at stake. Reluctantly, Madeline confirmed that Nina had given birth to a healthy baby girl, but Madeline had used a broker to adopt the baby out on the black market. Madeline claimed that she had not kept tabs of her granddaughter, but Valentin didn't believe her.

Madeline tried to blackmail Valentin by reminding him that Nina wouldn't be happy to learn about the visit, but Valentin warned Madeline that the illegal adoption would only result in extending Madeline's sentence.

On August 28, 2018, Nina was informed that her mother had passed away from a heart attack. Nina hired Curtis Ashford to look into it, and he confirmed that Madeline had died after learning that her parole had been denied. On September 6, Nina and Maxie had a small service for Madeline. Liesl had been on the lam when she had heard about Madeline's passing, so she had silently slipped into the church and hid in the shadows.

Liesl was alarmed when she learned that Madeline had died of a heart attack because there hadn't been any history of heart disease in the family, and Madeline hadn't had any of the risk factors. Liesl was certain that there had been more to the story. Later, Liesl witnessed Valentin approach Madeline's casket and take a sample of Madeline's DNA.

Days later, Nina received a box of mementos from her mother's attorney that included a special necklace with half a heart pendant. Nina was certain that Madeline had placed the other half of the heart with Nina's daughter.