‘Shockingly unique’: Why St. Louis program for antepartum moms is getting national attention

Kirsti Millar’s water broke when she was 23 weeks pregnant. 

Against all odds, her team of doctors at St. Luke’s Hospital in Kansas City delayed the delivery of her son, Olson, for 11 weeks. But it required Millar to move into a hospital room until then. 

She hung photos and string lights across the room and brought a hot pink coffee maker from her office. She took work meetings from bed, changing into a pair of “daytime” sweats. And she posed for maternity photos at the hospital’s rooftop garden. But for Millar, who is a licensed professional counselor, the isolation was impossible to avoid.

“I am equipped with every skill in the book. I am a provider for God’s sake,” Millar said. “I have resources at my fingertips, and I still cried myself to sleep multiple times a week just praying that my baby was going to be okay.”

While Millar’s exact circumstances were unique, giving birth before a baby reaches full gestational age is not uncommon in Missouri, which ranks 37th worst in the country for preterm birth rate.

In 2024, more than 7,400 babies born in Missouri — or 11% — were preterm, before 37 weeks gestation, according to March of Dimes. This also means many expectant mothers find themselves packing suitcases for hospital stays that last longer than a couple nights.

“I think one of the biggest risks here is once you get past the initial shock of being in the hospital, maybe your baby being born really early, the boredom sets in,” said Dr. Carrie Duffy, an OB-GYN and laborist with Saint Luke’s Hospital’s Maternal Fetal Medicine Specialists who was part of Millar’s care team. “And then it’s very hard mentally just to be in a small room for a long time, even though our nurses are great about trying to get them up and interacting and all of that.”

It’s been three years since her son’s birth, and Millar still daydreams of someday helping provide more mental health support to women admitted to the antepartum unit for weeks or months at a time ahead of giving birth. The hospital staff were irreplaceable, she said, but she was also desperate for a community of other moms.

“Pregnancy complications can feel really isolating,” Millar said. “A lot of times, our society portrays pregnant women as warriors and beautiful, and pregnancy as easy. … But there’s so much toll that it can take on a woman, and I just don’t think that’s talked about enough.”

One of Millar’s friends is a nurse at Barnes-Jewish Hospital in St. Louis where a longtime antepartum program meant to bridge the gap between hospital rooms is starting to get more notice. 

Every Thursday for the past 15-some years, women waiting to give birth gather to do arts and crafts as part of the hospital’s Arts + Healthcare Program. 

The craft time, which is a form of group therapy, acts as a lifeline for moms in the antepartum unit, many of whom are also navigating being away from their families while figuring out work, finances and child care for their other children.

“Pregnancy by itself is a risk factor for depression and anxiety,” said Joanna Rosenthal, who works part-time as a coordinator with the perinatal behavioral health service at Barnes-Jewish Hospital. “Then hospitalizations exacerbate some of those vulnerabilities, like social isolation, separation from support.” 

But, Rosenthal said, having integrated behavioral health support in an antepartum unit is “shockingly unique” despite the positive effects it has on women who can share their stories and experiences with one another.  

On a recent unseasonably warm February afternoon, Emily Paino-Brenneman, the program’s coordinator, rolled a large kart full of colorful socks, thread and a sewing machine into a sunny room overlooking Forest Park.

The project on deck? Sock monkeys. 

For the next two hours she helped two patients and two nurses make their own stuffed animals, carefully selecting silly patterns and hand-stitching buttons as they chatted about everything from medical diagnoses to baby names to favorite lunch spots.

Paino-Brenneman, who has a background in nursing and interior design, took over the program about a year ago after Sarah Colby, who launched the antepartum art support group, retired. 

Sometimes they have a couple moms, sometimes they have a dozen. The crafts are what initially get moms in the door: painting onesies or memory boxes for ultrasound pictures, making baby banners or knitting baby hats. Friendship bracelets were a recent addition to craft week after being voted on by a group of moms. O

The arts program, which is funded entirely by the foundation at Barnes-Jewish Hospital, is the only such program in the Midwest, Paino-Brenneman said. She recently attended the National Organization for Arts and Health Conference in New York where St. Louis’ program garnered attention. 

”I get a lot of calls like, how do we duplicate this?” she said.

Colby, the former director, said the antepartum art group came to be after a local chaplain at the time told her the antepartum moms could benefit from getting out of their rooms more often. 

The class was a hit. Colby said over the more than a decade she spent leading the group, she saw moms from all walks of life: new moms, moms in their 40s with multiple children, moms actively using drugs, moms who also worked in the labor and delivery unit, moms who lived 5 minutes away and moms who lived three hours away. What they all had in common was the shared experiences of trying to bring their babies into the world as safely as possible amid a mountain of uncertainty. 

“It takes the edge off what could be a frightening experience,” Colby said.

Last spring, Amy Neal was among the moms admitted to BJC’s antepartum unit after her water broke at 26 weeks and 6 days. In the month she spent in the unit, Thursdays quickly became her favorite day. 

Colby even brought a sewing machine to Neal’s room, where Neal, who teaches family and consumer sciences to high schoolers in her hometown, Cape Girardeau, made a blanket for her son, as well as for another mom she befriended at arts and crafts.

Neal’s son spent five months in the NICU after he was born. She rarely left his hospital room during the day, but when she did, it was to drop back by arts and crafts. She passed along advice and tips to expectant moms. It was one of the only times she didn’t feel alone.

“I don’t know why every hospital doesn’t have this program,” she said.