“Sometimes your questions are a little hard,” says Irene, an open adoption facilitator, in Louis Theroux's Altered States (BBC2), having just helped Jessica hand over of her new-born child to another woman. “People need to get a sense of how hard it is,” Theroux replies. “Just because they’re not expressing it, doesn’t mean they’re not feeling it deeply.”

Theroux, as nearly always, is right. Jessica passed out during childbirth and has not seen her nine-pound baby; the other woman, Cat, is cradling the child, having already adopted it. Is Jessica feeling loss? Does she know she has a legal right to keep the baby? Has she changed her mind?

The third and final part of Altered States series centres on pregnant mothers who offer up their still-gestating babies for adoption. Where the polygamy episode was an exploration of the unconventional and the second instalment's look at euthanasia was deeply distressing, “Take My Baby” is somewhere in between the two, teetering between uplifting and upsetting.

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As with the previous episodes, Theroux follows three separate cases. First, we are introduced to Patricia, a young mother of three who is pregnant again. Irene (mentioned above) connects Patricia with Amy and Ari, a sweet couple who excitedly await their new daughter – they name her Maya, buy her clothes, and tell other parents they’re expecting.

However, we soon learn of Patricia’s ulterior motive: money. Amy and Ari are paying a hefty sum for Maya – around $40,000 – and when Patricia decides to run away with the baby, they’re heartbroken. The money’s not the issue; their child has been stolen. It’s devastating and a stark warning against open adoption.

At the opposite end of the spectrum there’s Isiah, a boy who has been adopted by Joanne and now they are meeting Isiah’s real mother. Theroux watches events unfold, only asking the customary tough questions when both women are separate. As with last week, his empathetic nature shines as this success story – one of a child bringing two families together – unfolds.

Finally, there’s Jessica. Her story carefully balances the happiness of two parents gaining a baby with the immeasurable loss of a mother handing over a child. Perhaps the most harrowing moment of all comes from Jessica’s mother, who doesn’t want to give away her grandchild. “It’s like a death in the family,” she tells Theroux. “This is the grieving process.”

At times, Theroux shows his hand, such as with Patricia’s story, where he makes it clear through narration that something’s amiss before the dark twist becomes clear. Another rare misstep from Theroux comes when he pushes Jessica on feeling loss, in the process failing to help the viewer understand why she was adamant about giving up the baby.

But, for the most part, we are offered an even-handed look at open adoption that draws few conclusions. Asking the hard questions without ever overstepping boundaries, Theroux is on typically astute form, his masterly command of conversation shining through. Altered States is indeed another fine series to add to his already remarkable compendium of films.

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