An incapacitated woman is pregnant and no one notices? How does that happen?

There is one piece of good news in the stunner of a story of a woman who gave birth last month despite spending the last decade incapacitated at a Phoenix long-term care facility.

A healthy baby boy is now in the arms of his family, members of the San Carlos Apache tribe.

"The family obviously is outraged, traumatized and in shock by the abuse and neglect of their daughter at Hacienda Healthcare … ," the family's attorney, John Micheals, said in a statement. "The family would like me to convey that the baby boy has been born into a loving family and will be well cared for."

That, however, is where the good news ends and a raft of questions begin. 

Chief among them: Who raped a defenseless woman — one who has been in a persistent incapacitated state for more than a decade after a near drowning?

The details are appalling

Phoenix police are obtaining DNA samples from all male employees. Perhaps that will turn up the rapist. If it wasn’t one of them, then I’m guessing police will turn to the patient’s visitor log.

Assuming, that is, Hacienda Healthcare keeps track of visitors.

Or patients, for that matter.

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AzFamily broke the shocking story of the surprise Dec. 29 birth at Hacienda Healthcare, quoting an unnamed source who said that nobody on the staff was even aware the woman was pregnant until she was "pretty much giving birth."

It took her "pretty much giving birth" for her caregivers to notice there was a problem?

"From what I’ve been told she was moaning," the source told KTVK reporter Briana Whitney. "And they didn’t know what was wrong with her."

That's beyond appalling. 

How is this 'industry leading' care?

Here's a 29-year-old woman who could do nothing for herself, someone who relied on professional caregivers for her every need … and according to a source who blew the whistle on this story, no one even knew she was pregnant?

This, at a privately-owned long-term care facility that touts “our position as an industry leader in caring for the intellectually and developmentally disabled.” 

If the "industry leader" employs caregivers who don't even know that one of their patients is pregnant until the moment when she is giving birth, one wonders how patients at the rest of Arizona's long-term care facilities are faring.

But for this utterly defenseless rape victim giving birth, it seems no one would have been the wiser that she was under attack — likely repeated attack, unless you assume she got pregnant after the first assault.

Hacienda Healthcare has ousted its longtime CEO Bill Timmons. That should be just the start of changes.

How many others are out there?

Here are three questions that the state, the county, Hacienda Healthcare and every other business in the business of providing care to the most vulnerable among us must confront and explain to the rest of us:

How is it that no one noticed that this woman was being victimized?

How is it that a patient, helpless to do anything for herself, could go for nine months without so much as a single caregiver realizing she was pregnant?

And finally – perhaps most importantly – how many other victims are out there at Hacienda or elsewhere, unable to defend themselves or even call for help when help is so desperately needed?

Laurie Roberts is a columnist at The Arizona Republic, where this column first appeared. You can follow her on Twitter: @LaurieRoberts.