After Sam delivered their daughter in the apartment he rented under a fake name, he and Patty took a few minutes to be alone with the baby before they had to give her up. "She's so beautiful," she whispered, running a hand down her little cheek to memorize the newborn's face. She wanted to remember this for the rest of her life. They both desperately wished they could keep the baby but there was no possible way. Both their hearts were breaking. "I love you, my precious little angel."
"I love you too," Sam murmured, trying to will away the tears. He kissed Patty and the baby, wishing this wasn't happening, that they didn't have to give their daughter up. He was suddenly thankful they had kept Penny out of this for plausible deniability in case the worst happened and the truth was discovered - they didn't need another witness to their heartbreak. "What would you have named her, if you could?" he questioned.
She shook her head. "Sam, I can't do this. It'd just make it worse than it already is." Patty sobbed and pressed a kiss to her youngest's forehead. She inhaled and exhaled a few times to pull herself together, wrapping the baby up in the blanket she had used with Prue, Piper, and Phoebe. "We need to go now. It's hard enough already."
Sam helped her stand up and they made sure the baby was safe and content before they bound her powers. Then they orbed to a church, making sure nobody saw them come in. "We can do this, Patty." He hoped he wasn't lying to her.
When they found a nun, Patty reluctantly handed the baby over to her. "We can't keep her - please make sure she finds a good home. My only request is that she has a "P" name."
The surprised nun could only nod as she started rocking the baby back and forth. "Of course. You're sure you can't keep this precious little girl?"
"We're sure," Sam firmly responded. They said their goodbyes to the newborn, ducked out, and then orbed back to the apartment. A sobbing Patty fell into his arms. "What are we supposed to do now?" she choked out.
His body shook with his own sobs. "I don't know, sweetheart. I just don't know. But we have to pull ourselves together and go back to normal." They couldn't alert the Elders that anything was amiss - they had worked too hard this past year to conceal the pregnancy and their daughter's existence. They couldn't interfere with Patty's daughters' destiny as the Charmed Ones, couldn't let anybody know that they had created this perfect little girl together. Maybe it wouldn't have to stay a secret forever but Sam doubted it.
Sam cleaned the apartment up, erasing anything that spoke to what had happened there today, and then took a still crying Patty back to the manor, where Penny promised to take care of her.
After she died, Patty sneaked in a glimpse of her fourth daughter just to check in on her but only did so once. And when she finally met Paige Nicole Matthews for the first time after Prue's death and the Charmed Ones were reborn, she had to admit that any name she could have chosen would have paled in comparison. She had four wonderful daughters and Patty was proud of all of them.