Care and Support During an Obstetrics Emergency [Emily Jacobsen - Emergency OB]

My name is Emily Jacobsen. I'm from Yankton, South Dakota, and I teach at the high school. I have a 3-year-old Pacey and a 2-1/2-month-old Hannah. Pacey, I think, because he was early, he is super wild, runs all over the house. Hannah was only born a week early, and she is super calm. She only cries when she's hungry. So it is very different, but they're both awesome.

Why did you initially come to Brookings Hospital's OB triage?

I felt so sick, and I couldn't stop throwing up. I called my sister who's older and just had a baby like six months earlier than that, and she had said, "I'm sure it's just Braxton Hicks contractions. You're fine." But then it was about 30 minutes after I had stopped throwing up, I kind of felt something on my stomach, and so my husband and I both came to the ER.

Why did the OB triage doctor send you to Sioux Falls?

She had said, "I think you might be in preterm labor." And so we went to Sioux Falls. We sat down with the doctors, and they had looked at the scans and everything, and they still had decided that it was preterm labor. So they sent us home the next morning and the whole way home, I couldn't stop throwing up again, and I was like, "This is just...something is wrong." I think I have a pretty high pain tolerance, and I, like, convinced myself that it was just Braxton Hicks contractions again. But then my husband was like, "We need to go back to the hospital."

What happened when you returned to the Brookings OB triage?

My husband was out in the hall, talking with the OB, and I had screamed his name, I guess, and it looked like I described it to him like a balloon hotdog. It was coming out of my stomach. Like, you could visually see it, and so our OB had come in, and she said, "We need to order an MRI right away because I think it's something way more than preterm labor."

What did your OBGYN see in the MRI results?

Something was wrong with my colon. It's called...cecal volvulus is the full term for it, and she had said that it was starting to separate and turn, and so that's why they sent me to Sioux Falls the second time.

What do you remember from the ambulance ride to Sioux Falls?

I was so out of it, but I do remember when I was in the ambulance, the nurse who was with me who taught the classes online, she was with me and the ambulance driver, and they were making jokes back and forth, and I remember laughing. I remember thinking in my head like, "This is exactly who I would want to be with, like, if I don't make it." Like, I just always remember. Even when I had gotten home, I'm like, "Barry," who is my husband...I said, "We have to write a thank you to the ambulance driver," because he was amazing. And it was little things like that that, again, I was in so much pain that I don't remember everything, but I do remember that, and I was so thankful. I'm like, "Oh, okay, you know, like, I'm gonna get through this."

What did you learn about your surgery while recovering?

When we had met with two doctors, and they were talking us through the surgery, and it said neither one might make it out of surgery because they didn't know if they would be able to keep my son alive and me at the same time while they were doing this surgery. I didn't realize how big of a deal it was, what kind of pain I was in, and the surgery itself until I was in the elevator and there was another doctor with me, and she had said, "You must be the modern miracle." And I was like, "What?" And she said, "No one had ever heard of the surgery that you had in a pregnant woman, and they're shocked that they were able to do it and that you guys are both fine, you and the baby." And it was kind of then that I realized that it was something bigger than myself.

Why did you appreciate clear communication during the emergency?

Everything that we had asked our OB and even the nurses in Sioux Falls, they had broken it down for us. Like, I remember my husband saying, "Well, what does that mean? You know, can you explain it a little bit better?" Especially when we had come back to the ER the second time, my husband's like, "Something is wrong," and Dr. Sholes had agreed. She said, "Yes, something is definitely wrong. Here's what we have to do, and this is what we'll see if we do it." So I think everything was explained in a way that we could understand, and that made it a lot more comforting because it was such a scary situation. And, again, I'm talking about it, but I can't really say how terrified my husband was because I was in so much pain at the time, but I think my husband was very worried.

How could things have been different without the Brookings OB triage?

That one always kind of trips me up, I think, because Dr. Sholes had told my husband that it was kind of a matter of hours until something could have happened that was fatal. I'm really thankful for the team for figuring it out, and I know what Dr. Sholes had said and other nurses had told her, like, "We're so thankful that you ordered the MRI, because if you wouldn't have done that, we wouldn't have known what happened," so...

How long did you recover from surgery before going into labor?

So I had 21 staples, like, from my bra bone right to the top of my belly button. They had discharged us, and my dad had come to stay with us because I couldn't really move with the staples. It was pretty painful. We were at home, I think, for six days, and my water broke. And I remember telling my husband, "My water broke," and he was like, "No, it can't," and I said, "Yeah, it did. I think we need to go back to the hospital." And he's like, "But I don't have my bag packed," and I'm like, "Are you kidding? I don't care. We need to go back to the hospital." So then we came back here, and he was born, I think, within the hour with Dr. Abele, so...

How did the staff support you during labor and delivery?

I was a little nervous at first because Dr. Sholes was my OB for 32 weeks, but Dr. Abele introduced herself. She was very...a very calm presence. She had come in, and then she had said, "You know, I understand that on your birth plan you want to have an epidural, but I think your baby is going to be born too soon. I don't think that you can do that." And then I actually remember showing her my stomach and saying, "I have 21 staples. I cannot have a baby without an epidural." And so they had gotten the guy to do the epidural, and everything worked out. Dr. Abele is an angel. She is amazing.

What happened after delivery?

Since he was so early, they had called the care team from Sioux Falls, and they had come, and they let me hold him. But then they hooked him all up to the incubator, I think it was, and then it was like 10 minutes, and then we were in a corner room, and so we got to watch him take the helicopter to Sioux Falls. But I had preeclampsia, so I had to stay for 24 hours, but it was nice to be able to see him go.

What did you appreciate most about your care at Brookings Health System?

Everything that they explained, and it was really step-by-step. I did not know what to expect. I mean, I took the classes online, my husband did too, but when you're in here, it's a totally different experience. But I think, again, every nurse when they came in, when they changed my IV or when they said, "You have to take this medicine," they explained why in a way that I could understand. So that really helped me. It is the best option. I could never talk or say enough good things about the health system.

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