Introduced by executive producer Frank Valentini and created by head writer Ron Carlivati, Ava is introduced as the ex-lover of Robert "Franco" Frank (James Franco, Roger Howarth), and mother of his presumed daughter Lauren Katherine "Kiki" Jerome (Kristen Alderson, Hayley Erin), the missing heiress to the Quartermaine family fortune.

An art dealer by day, in July 2013, Ava is revealed to be the previously unmentioned youngest child of the infamous Jerome crime family, introduced to the series in the late 1980s.

Ava's attempt to use her daughter's faked paternity to get power at ELQ Industries is a part of her scheme with big brother, Julian Jerome to reclaim their family's territory from resident mob boss, Sonny Corinthos (Maurice Benard).

West's performance has been met with critical acclaim, winning her the Daytime Emmy Award for Outstanding Lead Actress in a Drama Series in 2015.

You have to put your faith in people, which was hard because I'd never met [executive producer] Frank Valentini and [head writer] Ron Carlivati, but they are so fun, so infectious!

If Ava's connection to the notorious Jerome crime family panned out, not only would West's arrival cause trouble for Port Charles's local kingpin, Sonny Corinthos (Maurice Benard), but there was also great storyline potential for Ian Buchanan and Finola Hughes's Duke Lavery and Anna Devane who shared a quite volatile history with the Jerome family.

[7][15] Critics began speculating that the character would be the long lost daughter of Tonja Walker's Olivia St. John (born Jerome) despite the relatively small age difference between the actresses; however Matt Webb Motivich of TVLine also suggested that Ava could be a previously unknown child of Olivia's crime lord father, Victor Jerome (Jack Axelrod).

"[20] West also spoke about her alter-ego's revelation that she was carrying the next Corinthos family baby., stating: That it's a classic soap story that has worked since television began.

"[21] In early 2015, Ava (after escaping from prison) is shot by Carlos Rivera (Jeffrey Vincent Parise), as revenge for causing him to be falsely imprisoned, and falls from a bridge.

[23] Silas Clay (Michael Easton), who has stashed Ava in a secret hospital room in New York, informs her that she has cancer and is dying, with her condition quickly worsening.

Luke gets Ava to confess that she was once involved1 with the crazed artist Robert "Franco" Frank (Roger Howarth) and that he fathered her daughter, Lauren Katherine "Kiki" Jerome (Kristen Alderson).

Ava follows her daughter to Port Charles and has an impromptu meeting with Tracy Quartermaine (Jane Elliot) over Kiki's shares, and manages to work out a deal that would endow her with a large money sum.

[28] Ava then confronts her daughter about the latest revelations and confesses that her father is in fact alive, leaving Kiki in a state of anger against her mother.

When Ava's older brother, the presumed dead Julian Jerome (William deVry) arrives in town under the alias "Derek Wells", the two reveal how their gambling ring involvement with Morgan was all in a hoax to work their way into the Corinthos family crime organization.

Teaming up with Madeline, Julian and Sonny, she breaks out of prison, only to be shot in the chest by Carlos and believed to be dead when her body is not found after falling into a river.

One month after her loved ones believe her to be dead, a doppelgänger by the name of Denise DeMuccio arrives and claims to be inquiring about Ava's family, considering their resemblance.

When confronted by Silas, Denise confesses to being Ava and that she teamed up with her mother to pull off the switch in an attempt to be in the lives of her daughters without the threat of the PCPD or Sonny.

While traveling, Ava and Nikolas (under the alias of "Niall Carradine"), run into Huxley Lynch (Trent Dawson), who ultimately entraps them within his home.

"[30] In the June 10, 2013, issue of ABC Soaps In Depth magazine, editor and chief Richard M. Simms named West and her character were listed as one of the top five enjoyable things about the series at that time.

[32][33] Based on her portrayal of Ava Jerome, Michael Logan of TV Guide, called West "the soap sensation of the decade".

He praised West saying: "Her performance as high-strung, power-mad mob spawn Ava Jerome is a noirish marvel — deadly, campy and defiantly sexual.

"[39] Daytime Confidential also listed West's arrival of Ava and the return of the Jerome crime family as number nine on their "10 Best Soap Opera Storylines of 2013".

They said, "When sultry gallery owner Ava Jerome (Maura West) was first introduced, fans and Port Charles citizens alike took notice of her infamous surname.

"[41] Michael Fairman of On-Air On-Soaps named West's debut as Ava Jerome as "Best New Character, Female" as part of his Best and Worst of 2013 list!.

We didn't think it was possible to love a character played by the actress more than we adored As The World Turns' Carly Snyder, but boy-oh-boy were we wrong!

"[44] In early 2014, West received a pre-nomination for the Daytime Emmy Award for Outstanding Lead Actress in a Drama Series, her sixth potential nomination in the category.

Clifford further stated that Ava's arrival "forever changed the face" of General Hospital and classified the character as one of the best in the soap's long history".

[60] Canyon News' editor Donald also praised West's work, calling it "flawless" and "riveting," while also crediting her performance for making General Hospital "can’t miss TV right now.

[66] In March 2023, Soaps.com editor Charlie Mason placed Ava at number six on his list of "General Hospital's 40+ Greatest Characters of All Time," commenting: "A tragic victim of circumstance, a stone-cold femme fatale or a little bit of both?

"[67] In December 2024, as part of their year-end listings, Soap Opera Network named West (for her work as Ava) as their seventh-top female performer.