Raising a child is hard when the mother is barely out of childhood herself.

An inexperienced, expectant mother faces emotional and physical changes and financial and educational challenges. Not to mention, she must acquire the parental knowledge needed to raise and care for a baby.

Cesily Sanders of North St. Louis found herself in this exact situation when she enrolled at the Teen Pregnancy Center at Barnes-Jewish Hospital in 2005.

Now, she is 17, but at the time her pregnancy occurred and her son was born, she was only 15. Sanders came to the program when she was six months pregnant, she said.

She concealed her pregnancy and didn''t receive medical attention until she was more than half way into her pregnancy. Professionals and peers at the center prepared her for childbirth, provided necessary prenatal medical care and taught her the skills necessary to be a good mother.

"It helped me be more organized with my son," Sanders said.

She now finds herself on the other end of the spectrum. Sanders serves as a peer assistant in the Peer Assistants Project at the center, where she assists medical staff with medical assessments, as well as answering questions, sharing her experience and providing advice to pregnant teens and new mothers.

The Peer Assistants Project has played a vital role. It provides expectant mothers with examples of how services and programs at the center can help them in their pregnancy, overcome challenges, prepare for childbirth and be productive parents. The center opened in 1999 and the Peer Assistants Program was put into place in 2002.

"They are the best way to describe our program to our current patients," said Lorien Carter, coordinator for the Teen Pregnancy Center at Barnes-Jewish Hospital.

Sanders, Tran''a Agnew and Mary Beth McGee, all whom were hired in March to be peer assistants, find themselves answering questions from soon-to-be mothers. Sanders is frequently is asked about the epidural, an injection of anesthesia that is given in the back to ease labor pain.

"How big is (the needle). Some are scared of shots," Sanders said. "I tell them to relax because you don''t want to move. It''s best not to look because I didn''t because I''m scared of needles myself."

Pain is a big topic among the pregnant girls. Agnew, a 16-year-old Benton Park resident, said she is often asked if it is painful to have a baby? Agnew is honest and says yes. However, she does offer a key piece of advice by telling them the key to getting through labor is staying calm.

After 25 hours of labor, Agnew gave birth to her daughter six months ago. She admits there are hard things about being a teenage mother, but believes babies are a gift from God.

She acknowledges that being a mother has changed her life completely.

"I can''t have a regular teenage life," she said.

McGee, a resident of the West End neighborhood, who was pregnant and had her baby at 16, fields similar questions to those asked of Agnew.

"''What was labor like?'' Contractions were the hardest part," said McGee, 18.

"''How was breast feeding?'' It''s easier, doesn''t cost money and you lose weight faster," she said.

There are only two requirements for pregnant women to enroll at the center. The mother must be under 18 when she starts at the center and must be Medicaid eligible. Most come during their first and early second trimesters, which is 14 to 18 weeks, Carter said.

Patient referrals come from pediatricians, school nurses, community agencies, word of mouth and through the Barnes-Jewish hospital main line. Health care professionals learn about the center for teens through health fairs and brochures sent to youth serving agencies, pediatricians and churches.

The skills Sanders learned at the center have paid off, which is why she feels it only right to give back as a volunteer at the hospital.

"I like helping people out. I like the position because the peer assistants helped me," Sanders said.

Peer assistants are hired once a year. Fliers and applications are sent to mothers who delivered within that past year. Once applications are received, the center staff conducts interviews and selects the volunteers.

Peer assistants are hospital volunteers and work from 3 to 7 p.m. each Monday.

"We recognize their efforts and time here through gift cards that they can use for themselves and this babies," Carter said.

For each session a peer assistant earns a $40 gift card to grocery and retail stores, including Schnucks and Target. The cards help them learn how to manage their finances. Funding from the March of Dimes makes the gift cards possible, Carter said.

McGee provides some tips to making it through a challenging situation.

"Always be motivated. Set goals and finish the goals," she said.

Sanders is determined and working hard to provide a good life for her 17-month old son. She is employed in a restaurant at the Saint Louis Science Center, is working on getting her General Equivalency Diploma and plans on attending nursing school.

Sanders offers a tip for others in her situation: "Just get support and don''t stress out."

The Barnes-Jewish Hospital''s Teen Pregnancy Center provides medical services during pregnancy, educational sessions on pregnancy and parenting, and screens for postpartum adjustment problems after a birth. It serves clients from the St. Louis area.

Here are some statistics about the center''s clients:

• Ninety percent are African American.
• Eight percent are Caucasian.
• Two percent are immigrants.
• The average age of expectant mothers who come to the center are 15 and a half.