"Your best friend and your boyfriend, the two people you hang out with most in your life, all of a sudden start hanging out together and you're not allowed to be with them or talk to them about it." In 2008, One Life to Live launched a storyline featuring Starr focusing on teen pregnancy as part of The National Campaign to Prevent Teen and Unplanned Pregnancy.
Despite disapproval from some fans — as well as Starr's father, Todd — Starr and Cole have sex for the first time in March 2008.
Starr finally learns the truth [that her child was switched at birth by her cousin Jessica (Bree Williamson)'s alternate personality, Bess, when Jessica's baby is stillborn] and she is finally reunited with daughter.Kramer discussed the campaign's history with ABC and also gave some facts about the storyline: Starr's decision to put the child up for adoption and the child's supposed "death" eventually drives the couple apart.By 2009, Cole is struggling with a drug addiction and Starr's attempts to help him deal start to bring them closer together.On February 24, 2012 Kristen Alderson brought her alter-ego Starr Manning over to the soap opera General Hospital.Cole & Hope were driving to Llanview, but their life was cut short when they died in a car accident caused by Johnny Zacharra attempting to shoot out Anthony Zacharra's tires.
Starr does her best to comfort a grieving Cole when Marty (Christina Chambers) is "killed" in an explosion.