Following Steffy's marriage to Liam, Katie is forced to deal with her ambivalence of not wanting her in the family. Bill and Steffy manipulatively work together to cover up their work of trying to keep Liam for reuniting with his former girlfriend, Katie's niece Hope. Katie finds out and helps Liam and Hope upon their reunion, though her relationship with Bill weakens as his disapproval of Hope grows. However, Katie and Bill are brought closer upon the news of Katie's pregnancy. Though high-risk, Katie goes ahead with the pregnancy, and nearly dies while delivering William "Will" Spencer, her firstborn. The shock, though, causes her to develop postpartum depression. During this period, she runs away and tries to have Bill leave her to be with his sister Brooke, whom Katie feels will be a better mother and wife.