Progestin only pills and Emergency pill

 🌸 Family Planning Series – Week 2: Progestin-only Pills (POPs) & Emergency Pills 🌸

Not all contraceptive pills are the same. Today we focus on two important types:

🔹 1. Progestin-only Pills (POPs – “Mini pill”)

Composition: contain only progestin (no estrogen).

How they work: mainly thicken cervical mucus, thin the endometrium, sometimes suppress ovulation.

Best for:

Breastfeeding mothers.

Women who cannot take estrogen (e.g., smokers >35, clotting disorders).

Key point: must be taken at the same time every day. Missing a pill by >3 hours can reduce effectiveness.

✅ Advantages: Safe during lactation, fewer contraindications.

⚠️ Disadvantages: Irregular bleeding, strict timing.

🔹 2. Emergency Contraceptive Pills (ECPs)

Purpose: prevent pregnancy after unprotected sex or contraceptive failure.

Types:

Levonorgestrel (LNG): most effective within 72 hrs.

Ulipristal acetate: up to 5 days after unprotected sex.

How they work: delay ovulation; do not terminate pregnancy.

Key point: the earlier they are taken, the more effective.

✅ Advantages: last-chance protection, widely available.

⚠️ Disadvantages: not for regular use, may cause nausea/irregular bleeding.

💡 Key Message:

POPs are for daily, long-term use, while emergency pills are a backup method only. Always consult your doctor to find the safest choice for you.

#DrRababCares 

#FamilyPlanning #POPs #EmergencyContraception #WomensHealth #ForestParkHospital

Share:

Read More

Post date pregnancy when pregnancy goes beyond the due date

 ⏳ Postdate Pregnancy – When Pregnancy Goes Beyond the Due Date

Most pregnancies end between 37–40 weeks. However, about 5–10% of women remain pregnant beyond 42 weeks — what we call post-term pregnancy.

⚠️ Why it matters:

Placental function can decline after 41–42 weeks.

Amniotic fluid volume decreases, raising the risk of cord compression.

The risk of stillbirth increases gradually after 41 weeks (from around 1–2 per 1,000 at 40 weeks to 2–3 per 1,000 after 42 weeks).

Larger baby size raises the chance of shoulder dystocia and cesarean delivery.

📌 Guidelines (ACOG / NICE / RCOG):

40 weeks onward: 

Weekly or bi-weekly monitoring with ultrasound (AFI), Doppler if indicated, and non-stress tests (CTG).

Induction of labor: 

Recommended at 41+0 to 42+0 weeks, as induction at this stage reduces the risk of stillbirth without significantly increasing cesarean rates.

Expectant management: 

Can be considered if monitoring is reassuring, but not beyond 42 weeks.

📊 Evidence:

Studies show that induction at 41 weeks lowers perinatal mortality and morbidity compared with waiting longer.

Cesarean delivery rates are not significantly higher with induction compared to waiting for spontaneous labor.

👩‍⚕️ Message for mothers:

It’s normal to go a little past your due date — but don’t skip monitoring.

If your pregnancy reaches 41 weeks, talk to your doctor about induction.

Every day after 41 weeks needs close observation to ensure baby’s safety.

🌸 Pregnancy is a journey full of patience and hope, but making decisions at the right time is what keeps both mother and baby safe.

#DrRababCares 

#PostdatePregnancy 

#SafeMotherhood

 #WomenHealthMatters

 #EvidenceBasedCare

 #ObGyn

#ForestParkHospital

Share:

Read More

Water the simplest gift you can give your pregnancy

 💧 Water: The simplest gift you can give your pregnancy

During pregnancy, your body works harder than ever — your blood volume increases, your baby’s cells are forming, and your organs are supporting two lives.

Drinking enough water is not just about avoiding thirst; it plays a key role in your baby’s growth and your own comfort.

Why water matters during pregnancy:

🫀 Supports circulation — helps deliver oxygen and nutrients to your baby.

🌊 Maintains healthy amniotic fluid levels — essential for your baby’s movement and protection.

🚫 Prevents constipation — keeps your digestive system moving smoothly.

🦠 Reduces the risk of urinary tract infections — flushing out bacteria naturally.

🌡 Helps regulate body temperature — important when your body is working extra hard.

💆‍♀️ Eases swelling — good hydration can help reduce water retention in ankles and hands.

⚠️ Did you know? Even mild dehydration in pregnancy can cause headaches, dizziness, and increase the risk of preterm contractions — so don’t wait until you’re thirsty to drink.

Tip: Aim for 8–10 glasses a day, spread throughout your day, and choose water over sugary or caffeinated drinks 

 We remind every mom-to-be that small daily habits make the biggest difference for a healthy pregnancy. 🌸

#DrRababCares

 #PregnancyHealth 

#WomenHealthMatters

 #LusakaGynae 

#HydrationForHealth

 #ForestParkHospital

Share:

Read More

The heartburn myth

 😂 Funny Fridays – The Heartburn Myth 😂

One of the funniest things I hear from moms-to-be is:

👉 “Doctor, my heartburn is so bad… it must mean my baby has a lot of hair!” 🙈

✨ Here’s the truth:

Heartburn in pregnancy has nothing to do with your baby’s hairstyle. It happens because pregnancy hormones — especially progesterone — relax the muscle that normally keeps stomach acid where it belongs. Add the growing uterus pressing on your stomach, and voilà: acid finds its way up, causing that burning feeling in the chest. 🔥

So no, your little one isn’t secretly growing Rapunzel’s hair inside your womb. 😅 What you’re feeling is simply one of the most common and temporary pregnancy symptoms.

💡 The good news? You can reduce heartburn by:

Eating smaller, more frequent meals 🍲

Avoiding lying down right after eating 🛏️

Cutting down on very spicy, greasy, or acidic foods 🌶️🍋

Keeping your head slightly elevated when you sleep 🌙

💙 Remember: Heartburn is uncomfortable, but it’s not dangerous, and it doesn’t predict your baby’s look. What it does remind us is that pregnancy is full of funny myths — and a lot of love, laughter, and learning.

#FunnyFridays 

#PregnancyMyths 

#OBGYN 

#DrRababCares 

#LusakaGynae 

#WomenHealthMatters

#ForestParkHospital

Share:

Read More

IUI - When a gentle push makes all the difference

 💠 IUI – When a Gentle Push Makes All the Difference

Not every fertility case needs a complex, high-tech solution.

Sometimes, all it takes… is a timely and well-guided step forward.

That’s what IUI (Intrauterine Insemination) is all about.

🧬 What is IUI?

IUI is a simple, non-surgical fertility procedure where specially prepared sperm are placed directly into the uterus around the time of ovulation — giving them a better chance to reach the egg.

It’s quick.

It’s gentle.

It’s hopeful.

👩‍⚕️ When do we consider IUI?

✅ Mild male factor infertility (slightly low count or motility)

✅ Ovulation disorders or irregular cycles

✅ Cervical mucus issues

✅ Mild PCOS

✅ Unexplained infertility

✅ Use of frozen or donor sperm

🚫 When is IUI not recommended?

❌ Blocked fallopian tubes

❌ Severe sperm abnormalities

❌ Advanced endometriosis

❌ Poor ovarian reserve or age >38

❌ Failure of 3 or more IUI cycles

In such cases, IVF or ICSI might offer better outcomes.

📈 Success Rates

On average: 10–20% per cycle

May reach 25–30% with proper ovulation induction

Cumulative success increases over 2–3 cycles

Best outcomes in women under 35

🔍 How is it done?

Ovulation tracking (naturally or with stimulation)

Sperm preparation – selecting the best quality sperm

Insertion via a soft catheter into the uterus

Luteal phase support with progesterone

Pregnancy test after 2 weeks

The entire process is done in-clinic and takes just minutes — without anesthesia.

💬 A real-world story:

A 29-year-old woman with 2 years of infertility and borderline sperm motility.

We stimulated her ovulation with Letrozole, timed the insemination precisely, and performed IUI.

Today, she's expecting — naturally, gently, and joyfully.

Not every couple needs IVF.

But every couple deserves the right assessment and the right plan.

#DrRababCares

#FertilityCare #IUI #GynecologyZambia #ForestParkHospital #InfertilitySupport #HopeStartsHere #LusakaGynae #WomensHealth

Share:

Read More

Rainbow baby hope after the storm

 🌈 Rainbow Baby – Hope After the Storm

A “Rainbow baby” is the child born after the storm of loss — following miscarriage, stillbirth, or neonatal death. 

Just like a rainbow appears after heavy rains, these babies bring back colors, joy, and healing into lives that were once clouded with grief. They do not erase the pain of the storm, but they remind us that light can return, even after the darkest skies.

In my practice, I have seen this miracle. A woman who faced repeated miscarriages finally carried her pregnancy to term. When she held her newborn for the first time, she whispered: “This is my rainbow after the storm.” 🌈👶 That baby wasn’t just a child — it was a symbol of faith, resilience, and new beginnings.

❌ Sometimes, people who don’t know the meaning misunderstand the term Rainbow baby. They may think it is just a “cute” expression, or even confuse it with unrelated symbolism. But in reality, it is a deeply emotional term used with compassion and respect for families who have endured loss and finally found hope again.

👣🌈 Every step tells a story. These tiny rainbow footprints are a reminder that even after loss, new beginnings are possible, and hope can walk back into our lives one step at a time.

✨ As doctors, we are reminded that medicine is not only about science and treatment; it is about standing with women in their storms, and celebrating with them when the rainbow finally appears.

💙 To every mother who has faced pregnancy loss: you are not alone. Your rainbow may still come, bringing light and hope after the storm. 🌈

#DrRababCares 

#RainbowBaby 

#PregnancyLoss 

#HopeAfterLoss #WomenHealthMatters #LusakaGynae 

#ForestParkHospital

Share:

Read More

Polycystic ovarian syndrome

 🌸 PCOS: More than just irregular periods

Polycystic Ovary Syndrome (PCOS) affects 1 in 10 women worldwide.

It is not only about fertility — it also carries long-term health risks if left unmanaged.

Common symptoms many women ignore:

🔹 Irregular or absent periods

🔹 Acne, excess hair growth (hirsutism), or hair loss

🔹 Difficulty conceiving

🔹 Weight gain or insulin resistance

Too often, women are told:

👉 “It’s normal to skip periods.”

👉 “Just lose weight and you’ll be fine.”

👉 “You’re young, don’t worry.”

💔 But ignoring these signs means missing the chance to protect your fertility, heart, and metabolic health.

💡 Guidelines (ESHRE & Endocrine Society 2023):

✅ Diagnosis: Rotterdam criteria → any 2 of:

1. Irregular or absent ovulation

2. Clinical/biochemical hyperandrogenism

3. Polycystic ovaries on ultrasound (≥20 follicles or ≥10 ml volume)

✅ First-line management:

Lifestyle modification (balanced diet + regular activity) = cornerstone.

COCs regulate cycles & reduce excess hair/acne.

Metformin helps with insulin resistance & weight control.

Letrozole = preferred for ovulation induction when pregnancy is desired.

✅ Long-term care:

Screen for diabetes, hypertension, cholesterol.

Don’t forget the emotional side — anxiety and depression are more common in PCOS.

💙 Key Message:

If you suspect PCOS, don’t wait. Early diagnosis and simple interventions can prevent complications, improve fertility, and give you control over your health.

✨ Remember: your symptoms are valid, and seeking help is the first step toward healing.

#DrRababCares 

#PCOSAwareness 

#WomenHealthMatters 

#LusakaGynae

 #ForestParkHospital #FertilityCare

Share:

Read More

Menopause , science, care and compassion

 🌸 Menopause: Science, Care & Compassion

Menopause is a natural transition, not an illness. It usually happens between 45–55 years, when estrogen levels drop and the ovaries stop releasing eggs.

🔍 Symptoms many women face:

Hot flashes & night sweats

Mood swings, anxiety, or low mood

Difficulty sleeping

Vaginal dryness & intimacy challenges

Higher risk of osteoporosis & heart disease

💡 Management – according to guidelines (NICE & ACOG):

🔹 Lifestyle & Prevention

Healthy diet (calcium + vitamin D)

Regular exercise: walking, yoga, resistance training

Stop smoking, limit caffeine & alcohol

🔹 Hormone Replacement Therapy (HRT)

Gold standard for moderate–severe symptoms

Most effective if started <60 years or within 10 years of menopause

Benefits: reduces hot flashes, protects bones, improves sleep & mood

Risks: slight ↑ risk of breast cancer or clotting (must be individualized)

Review every 6–12 months

🔹 Non-Hormonal Options

SSRIs/SNRIs, gabapentin, clonidine → help with hot flashes

Vaginal estrogen or moisturizers → for dryness & sexual health

SERMs or bisphosphonates → for bone health

💙 Support matters:

Menopause can feel overwhelming — but no woman should go through it alone. Compassion, family support, and open conversations with doctors make all the difference.

👉 To every woman in this stage: you are not alone. Your body is changing, but your value, beauty, and strength are not fading. With awareness, guidance, and care, this chapter can be one of freedom, renewal, and resilience. 🌸✨

#DrRababCares 

#MenopauseAwareness #WomenHealthMatters 

#SupportHer 

#OBGYN 

#CompassionInCare 

#ForestParkHospital #LusakaGynae

Share:

Read More

The day my hands found what my eyes didn't see

 ✨🤲 The Day My Hands Found What My Eyes Didn’t See 👀✨

I was still a junior resident 👩‍⚕️.

A planned cesarean section 🍼.

One healthy baby girl — that’s what we all expected 💖.

The ultrasound, done by a senior consultant, was clear 🖥️: single pregnancy.

We were confident ✅.

I delivered the baby girl 👶.

She cried 😭.

We smiled 😊.

I handed her to the pediatrician 👩‍⚕️👨‍⚕️ and started closing.

Then… I paused ⏸️.

Something didn’t feel right 🤔.

I looked at the team and said:

“There’s another baby. There’s another baby!” 🗣️👶

They laughed 😂.

“Sure, doctor… maybe next week,” one nurse teased 😅.

Another said, “Don’t scare us like that.” 🙈

But my hands kept moving ✋, my heart racing ❤️‍🔥.

And then… I felt her ✨.

Small. Warm. Waiting 🍼💖.

Another baby girl 👶💗👶.

Two beautiful sisters, born minutes apart — one expected, one a complete surprise 🎁.

The room went silent 🤫.

Then came laughter 😄, joy 🥹, and disbelief 😲.

The mother’s smile said it all — double the love 💕, double the blessing 🙏.

🔍📢 Awareness Message:

While ultrasounds are a crucial tool in modern obstetrics 🖥️, they are not infallible.

Factors like fetal position 🤰, maternal anatomy 🫄, and late pregnancy changes 📅 can sometimes hide important findings — even a whole baby 👶.

That’s why regular antenatal checkups 🩺 and routine follow-up visits 📆 are essential. They allow us to monitor growth 📏, detect changes 🔍, and reduce the risk of surprises like this.

Technology guides us 💻, but it’s human judgment — supported by consistent follow-up — that truly safeguards mother and baby ❤️👩‍🍼.

#DrRababCares 

#DrRababMustafa 

#ForestParkHospital #LusakaDoctors #ZambiaHealthcare #OBGYN #MaternalHealth #SafeDelivery #BirthStory #PregnancyCare #WomensHealth #DoctorStories #LifeInTheOR

Share:

Read More

Pregnancy craving can be so dramatic

 🤣 Funny Facts

🤰

Pregnancy cravings can be so dramatic!

One expectant mom once asked me with a straight face:

"Doctor, if I don’t eat mangoes at midnight, will my baby be born with a mango-shaped birthmark?" 🥭😂

✅ Fact: Cravings are completely normal. They’re caused by hormonal changes that affect taste and smell, shifts in blood sugar, and sometimes even nutritional needs (like craving red meat when iron is low).

But here’s the truth — no, your baby won’t come out looking like the food you craved. Cravings don’t shape birthmarks or baby features. 🙃

⚠️ When to pay attention:

– Craving non-food items like soil, clay, ice, or chalk may be a sign of iron deficiency or anemia. That’s called pica — and it needs a doctor’s check.

– Extreme or constant cravings for sweets or carbs may signal gestational diabetes, so don’t ignore it.

And yes, sometimes you feel like you’re eating for two…

Which often means not one, but two (or three!) donuts 🍩🍩🍩 on the same plate — just to be safe 😉.

Pregnancy is full of funny myths — but it’s also full of signals your body is sending you.

So laugh at the stories 😄, enjoy your safe cravings 🍫🍓🍩… but never forget to listen to what your body is really asking for. 🌸

#FunnyFridays 

#DrRababCares 

#WomenHealthMatters 

#ForestParkHospital #LusakaGynae #PregnancyMyths

Share:

Read More

HPV what every woman should know

 🧬 HPV — What Every Woman Should Know

(Dr Rabab Cares 💜)

🌿 What is HPV?

HPV = Human Papillomavirus

It’s the most common sexually transmitted infection in the world.

There are over 100 types of HPV:

Some cause genital warts (low-risk)

Others can lead to cervical and other cancers (high-risk)

🔄 Can HPV be positive… and then become negative?

Yes — and it happens more often than you think.

> 💡 Over 90% of HPV infections clear naturally within 1–2 years, especially in healthy women under 45.

This means: 

✅ Your immune system fought the virus

✅ There’s no active infection

✅ Your HPV test can become negative again

Even if your Pap smear still shows mild changes (like LSIL), it doesn’t mean the virus is still there — it just takes time for the cells to normalize.

⚠️ When is HPV dangerous?

If high-risk types (like HPV 16 or 18) stay in the body too long, they can lead to:

Cervical cancer

Vaginal or vulvar cancer

Anal and throat cancers

That’s why we screen regularly — to catch any early changes before they become serious.

💉 What about the HPV vaccine?

The HPV vaccine is cancer prevention.

It protects against the most dangerous HPV types, and it’s:

✅ Safe

✅ Effective

✅ Approved by WHO, CDC, and leading medical bodies

👧 Who should get vaccinated?

Ideal age: 9–14 years (before sexual activity begins)

Catch-up: Up to age 26

In some cases: even up to age 45 (ask your doctor)

🔬 What do the experts say?

CDC: "90% of HPV infections are cleared by the immune system within 2 years."

WHO: "Most HPV infections are transient and asymptomatic."

The Lancet: "91% of infections cleared within 24 months." (Vol 364, 2004)

ACOG: "Most infections clear spontaneously in women under 30."

💬 Final word from Dr Rabab:

HPV is common.

But with good information, routine screening, and vaccination, we can protect our health and our daughters’ futures.

#DrRababCares

#HPVawareness

#HPVVaccine

#CervicalHealth

#PapSmear

#PreventCervicalCancer

#GynecologyZambia

#ForestParkHospital

#LinkedInDoctors

#WomensHealthHPV

Share:

Read More

Postpartum depression

 💙 Postpartum Depression:

 More Than Just the “Baby Blues”

Bringing a baby into the world is supposed to be a joyful experience. But for many women, it can leave deep emotional scars, even when everything goes smoothly from a medical point of view.

👩‍🍼 I met a young mother who delivered naturally, with no complications. From the outside, everyone celebrated her “perfect birth.” Yet, she sat in front of me in tears, saying:

“Doctor, I feel traumatized… I don’t even know why. Everything went well, but inside I feel broken.”

This is the hidden face of Postpartum Depression (PPD).

It’s not about the type of delivery or how smooth the process was — it’s about how a woman’s body, mind, and emotions process the experience.

🔎 Warning signs of PPD may include:

Persistent sadness or tearfulness

Feeling disconnected from the baby

Reliving the birth experience as traumatic

Sleep or appetite disturbances

Guilt, shame, or feelings of failure

In severe cases, thoughts of self-harm

💡 What mothers need to know:

PPD is not a weakness, and trauma can happen even after a “perfect” birth.

Emotional pain is just as real as physical complications.

Recovery is possible with the right support, therapy, and sometimes medication.

🌷 To mothers: Your feelings are valid. Healing takes time.

🌍 To families: Please listen, support, and never dismiss a mother’s emotions just because “the birth went well.”

#DrRababCares

#PostpartumDepression 

#WomensHealth 

#ForestParkHospital #MentalHealthAwareness 

#BirthTrauma

Share:

Read More

Postmenopausal bleeding

 🔹 Postmenopausal Bleeding: A Sign You Should Never Ignore

🌙 Life after menopause is supposed to be a stage of peace, stability, and freedom from monthly cycles. That’s why when bleeding returns — even a small stain — it should be treated as a warning sign.

✨ Why is it important?

Most of the time, the cause is not dangerous — things like endometrial thinning (atrophy), polyps, or side effects of hormone therapy.

But in about 1 in 10 women, it can be the first sign of endometrial cancer or other serious conditions.

💡 Early diagnosis = higher chances of cure.

🩺 Risk factors that increase concern:

Obesity

Diabetes or high blood pressure

Family history of gynecological cancers

Use of unopposed estrogen (HRT without progesterone)

Late menopause or never having children

👉 Knowing these factors helps women understand why doctors take postmenopausal bleeding so seriously.

🔍 What should be done?

See a gynecologist immediately — do not wait or assume it will go away.

First test: Transvaginal Ultrasound (TVUS) 

Thin endometrium (≤4 mm) → usually safe.

Thick endometrium (>4 mm) → need biopsy.

Endometrial biopsy or hysteroscopy → confirm the diagnosis.

Cervical screening / Pap smear may be needed if the cervix looks suspicious.

📑 Extra: Guidelines-Based Approach

🔹 NICE guidelines (UK):

Offer urgent referral (within 2 weeks) for any woman with postmenopausal bleeding.

TVUS is the first-line investigation.

If endometrium ≤4 mm → reassure but consider re-assessment if bleeding persists.

If endometrium >4 mm → biopsy ± hysteroscopy.

🔹 ACOG guidelines (USA):

Emphasize that any PMB warrants evaluation, regardless of the amount.

TVUS or endometrial sampling can be used as first-line, but biopsy is mandatory if risk factors present.

Recurrent bleeding with normal tests → hysteroscopy should be done.

❤️ Message to women:

Postmenopausal bleeding is not a normal part of aging.

It is your body whispering: “Please check me.”

Listening early can protect you from advanced disease, anxiety, and complicated treatments.

🌸 Practical tips:

Keep a small diary of bleeding episodes (dates, amount, color).

Don’t be shy to bring stained underwear/pads to your doctor — it helps us understand the pattern.

Encourage your mother, sister, or friend if they ever mention bleeding after menopause — remind them it’s never to be ignored.

📌 Key takeaway:

Even one drop matters. Postmenopausal bleeding should always be checked — because your health and peace of mind are priceless. 💙

#DrRababCares 

#WomenHealthMatters #PostmenopausalBleeding #EndometrialHealth 

#GynecologyAwareness

 #ForestParkHospital

Share:

Read More

Morning sickness

 Morning Sickness 🤰

It’s one of the most common symptoms of early pregnancy.

👉 It means nausea, with or without vomiting.

💡 Despite the name, it doesn’t only happen in the morning — it can strike at any time of the day or night.

In fact, many women tell me: “Doctor, why do they call it morning sickness if I’m sick all day long?” 😂

📊 It affects around 70–80% of pregnant women, usually in the first trimester.

⚠️ Why it happens:

Rising pregnancy hormones (hCG, estrogen).

Slower digestion.

Heightened sense of smell.

Low blood sugar.

✅ Usually: it’s mild and improves after 12–14 weeks.

🚨 But: if it’s severe, with constant vomiting, weight loss, or dehydration → this could be Hyperemesis Gravidarum and needs urgent medical attention.

🤣 Funny part: 

Some moms tell me, “Doctor, I couldn’t keep down anything… except French fries!” 🍟😂

So yes, morning sickness isn’t only in the morning — and cravings always have their own rules! 😉

#DrRababCares

#FunnyFridays 

 #WomenHealthMatters 

#PregnancyJourney 

#ForestParkHospital

Share:

Read More

Congenital thrombophilia

 Some women don’t lose their babies because of bad luck...

They lose them because their own blood silently turns against them.

🩸 Congenital Thrombophilia is a hidden risk — an inherited tendency for abnormal blood clotting that can cause heartbreak over and over again.

When tiny clots form in the placenta, they can block oxygen and nutrients from reaching the baby, leading to:

Unexplained miscarriages (especially after 10 weeks)

Intrauterine fetal death (IUFD)

Stillbirths

Severe preeclampsia

Placental abruption

Intrauterine growth restriction (IUGR)

It’s not just bad luck.

It’s biology.

🧪 If a woman has had multiple pregnancy losses, or a family history of thrombosis, or previous pregnancies with IUGR or severe preeclampsia — it’s time to investigate.

Because yes — there is something we can do.

💉 With proper management — low-dose aspirin and preventive anticoagulation (like LMWH or Clexane) — many women with thrombophilia go on to have healthy, full-term pregnancies.

And in IVF cases, we usually start treatment even earlier.

🌸 A story I carry in my heart…

She had lost three babies, all in the third trimester.

She came to me after the second loss.

I advised her to start Clexane in the next pregnancy.

But she didn’t.

The third pregnancy ended in tragedy again.

Another IUFD.

That was when we pushed for answers.

🧬 We found Protein C deficiency — a form of congenital thrombophilia.

This time, she followed the plan.

Clexane. Monitoring. Commitment.

And this time… life won.

She gave birth to a healthy baby boy.

Today, she sent me his photo — 8 weeks old, peacefully asleep in her arms.

She said:

"Thank you for helping me not give up. You gave me hope when I had none."

🫶 Not every pregnancy loss is unexplained.

Some just haven’t been explained yet.

And sometimes, one test… one decision… one doctor…

can make all the difference.

#DrRababCares 

#Thrombophilia

#RecurrentPregnancyLoss

#ProteinCDeficiency

#ForestParkHospital 

#HopeAfterLoss

#HighRiskPregnancy

#WomensHealthMatters

#EveryLifeCounts

#IUFD

Share:

Read More

Vitamin D a silent power in women's health

 🌞 Vitamin D – A Silent Power in Women’s Health

When we think of Vitamin D, we often picture strong bones and calcium… but in women’s health — especially gynecology and obstetrics — it plays a far bigger role.

Recent guidelines from the Endocrine Society (2024) have shifted how we approach Vitamin D.

It’s no longer just about preventing deficiency — it’s about optimizing levels to improve reproductive and pregnancy outcomes.

💡 Why it matters in Gynecology:

Fertility support – Adequate Vitamin D helps regulate the hypothalamic–pituitary–ovarian axis, improving ovulation and potentially boosting IVF success rates.

PCOS management – Studies show improved insulin sensitivity and menstrual regularity with adequate Vitamin D.

Pelvic health – Plays a role in muscle strength, which may influence pelvic floor health.

🤰 Why it matters in Pregnancy:

Lower risk of pre-eclampsia – Supplementation is linked to better placental function and reduced blood pressure complications.

Reduced preterm birth – Maintaining optimal Vitamin D may lower the risk of delivering too early.

Neonatal benefits – Supports skeletal development, immune function, and possibly neurodevelopment in the newborn.

📢 What’s new in the guidelines?

Empiric supplementation is now recommended for most pregnant women — without waiting for blood test results — because deficiency is so common.

Suggested dose: Around 2,500 IU/day (≈63 mcg) is safe for most, with higher doses in confirmed deficiency under medical supervision.

Testing is reserved for women at very high risk of deficiency (chronic illness, malabsorption, severe obesity).

☀ Zambia’s sunny weather doesn’t guarantee enough Vitamin D.

Indoor work, darker skin pigmentation, and cultural clothing can all limit natural synthesis. This means even here, many women — including pregnant women — have low levels without realizing it.

Taking care of your Vitamin D isn’t just a “wellness tip” — it’s a scientifically proven investment in fertility, pregnancy health, and long-term well-being.

#DrRababCares 

#VitaminD #WomenHealthMatters #LatestGuidelines #Obstetrics #Gynecology #ForestParkHospital #LusakaGynae

Share:

Read More

When post miscarriage bleeding doesn't stop

 When Post-Miscarriage Bleeding Doesn’t Stop

This young woman experienced post-miscarriage bleeding due to retained placenta after a 20-week miscarriage in another province.

Doctors attempted manual removal of the placenta, but it was complicated with severe bleeding. She needed two units of blood transfusion to stabilize her.

Yet, even after all that, the bleeding didn’t stop.

For two months, she continued to suffer from intermittent abnormal uterine bleeding, until she came to Lusaka seeking further care.

🔎 Diagnosis (Ultrasound with Doppler):

A vascular intrauterine mass, highly suggestive of a placental polyp.

🎥 Treatment (Intraoperative Hysteroscopy):

Direct visualization confirmed the diagnosis, and the polyp was carefully excised.

⚠️ It was one of those challenging cases that truly test your skills and patience.

The retained tissue had been inside the uterus for two months, firmly attached to the endometrium, with a real risk of significant bleeding during removal.

With precision, patience, and careful hysteroscopic guidance, we managed to remove it completely and safely.

💧 Outcome (Follow-up Ultrasound):

The uterine cavity appeared clear, with no abnormal vascularity, and the bleeding finally stopped.

🌟 Key message:

Persistent bleeding after miscarriage should never be ignored. Even months later, retained placental tissue can turn into a difficult, high-risk case.

But with timely diagnosis and minimally invasive hysteroscopy, safe recovery is possible.

Attached video of cavity after removal and ultrasound pictures of uterus before and after procedure.

✨ Update: Histopathology Results

Histopathology confirmed the diagnosis as retained products of conception (RPOC) with chorionic villi and decidual tissue showing degenerative changes.

This reinforces the importance of:

Always considering placental polyp / RPOC in cases of persistent post-miscarriage bleeding.

Using ultrasound + hysteroscopy not only for diagnosis but also as definitive treatment.

💙 Another reminder that timely intervention prevents complications and restores health.

#DrRababCares 

#PlacentalPolyp 

#Histopathology 

#WomensHealthMatters 

#Hysteroscopy

#ForestParkHospital

Share:

Read More

Endometriosis

 💛 Endometriosis – The Silent Struggle Many Women Face

Endometriosis is not just painful periods. It is a chronic condition where tissue similar to the lining of the uterus grows outside it—causing pain, inflammation, and sometimes infertility.

🔹 It affects 1 in 10 women of reproductive age.

🔹 Many go undiagnosed for 7–10 years due to normalization of their pain.

🔹 Symptoms often overlap with other conditions, which delays proper treatment.

📌 Guidelines & Key Clinical Notes:

Suspicion is key: Any woman with chronic pelvic pain, dysmenorrhea unresponsive to regular painkillers, or infertility should be evaluated for endometriosis.

Diagnostic approach: 

History & pelvic exam.

Ultrasound can detect ovarian endometriomas.

MRI helps map deep infiltrating disease.

Laparoscopy remains the gold standard for definitive diagnosis.

Management: 

Medical options: NSAIDs for pain, hormonal therapy (COCs, progestins, GnRH analogues).

Surgical options: Laparoscopic excision/ablation for severe disease, especially when infertility is a concern.

Multidisciplinary support: Pain specialists, fertility counseling, psychological support.

Follow-up: Chronic disease, requires long-term individualized management.

🌸 Endometriosis & Infertility

Around 30–50% of women with endometriosis may face fertility challenges.

The disease can distort pelvic anatomy, damage ovaries and fallopian tubes, and affect egg quality.

Surgical removal of endometriosis lesions may improve fertility in selected cases.

Assisted reproductive techniques (IVF/ICSI) are sometimes necessary, particularly when conservative measures fail.

Early diagnosis and tailored treatment increase the chance of conception and reduce emotional distress.

🌟 My Personal Reflection as a Gynecologist

What touches me most is how many women normalize their pain. They endure years of suffering in silence, not knowing it could also be the reason behind their infertility struggles. Awareness is the first step toward restoring women’s health, fertility, and dignity.

💡 Takeaway Message

👉 If you or someone you know suffers from severe pelvic pain or unexplained infertility, don’t ignore it. Early referral to a gynecologist can make all the difference.

#DrRababCares 

#Endometriosis #Infertility #WomensHealth #Gynecology #Awareness #DrRababCares #ForestParkHospital #zambiahealthcare

Share:

Read More

From 5 years of waiting..to tears of joy

 ✨ From 5 Years of Waiting… to Tears of Joy ✨

She first came to me last year with primary infertility for 5 years. We started treatment step by step… and by the second month of therapy, she conceived.

From that moment, she continued her entire pregnancy under my care – every scan, every check-up, every heartbeat we listened to together. We shared the worries, the excitement, and the prayers for this little miracle. 💙

Today, the journey reached its climax. During labor, the baby showed decelerations and the cord was seen around the neck on ultrasound. I had to act quickly with an emergency C-section.

And then… the most beautiful sound: the cry of her baby. She broke down in tears – not from fear, but from overwhelming relief, gratitude, and joy.

🌸 This story is more than medicine.

It’s about patience. It’s about walking through uncertainty, month after month, year after year. It’s about the courage not to give up when the road feels endless.

💡 Obstetrics is not only about science, but about humanity.

It’s about holding hands through fear, wiping tears in moments of despair, and sharing the joy when a long-awaited miracle finally arrives.

Infertility can be a silent battle, often filled with disappointment and tears. But behind every challenge, there is still hope. And sometimes, after years of waiting, God blesses us with the sweetest miracles. ✨

💌 To every woman who is still waiting:

Please, don’t lose hope. Every negative test, every failed cycle, every sleepless night — they don’t define your future. With the right care, support, and faith, joy can still come. And when it does, it wipes away years of pain in a single cry.

#DrRababCares

 #WomenHealthMatters

 #ForestParkHospital

 #InfertilityJourney 

#Hope

 #MiracleBaby 

#NeverLoseHope 

#Obstetrics

Share:

Read More

Ectopic pregnancy

 🩺 Ectopic Pregnancy – When Pregnancy Turns into an Emergency

Pregnancy is usually a journey of hope. But sometimes, instead of implanting in the uterus, the embryo grows in the fallopian tube or elsewhere outside the womb. This is called an Ectopic Pregnancy, and it is a condition that cannot continue — it threatens the mother’s life.

⚠️ Why it matters:

If undetected, the tube can rupture, causing massive internal bleeding within minutes. It’s one of the leading causes of maternal death in early pregnancy.

💡 Facts to Remember:

Affects 1–2% of pregnancies worldwide.

Risk factors: prior pelvic infections, tubal surgeries, IVF or fertility treatment, smoking, or a history of ectopic pregnancy.

Symptoms: sharp or one-sided abdominal pain, shoulder tip pain, vaginal bleeding, dizziness or fainting.

Diagnosis: blood test for pregnancy hormone + transvaginal ultrasound.

⚕️ Treatment depends on timing:

Early detection: sometimes can be managed with medication (Methotrexate) or a conservative surgery that preserves the tube.

Late detection: usually means the tube has already ruptured, leading to internal bleeding. In such emergencies, the only life-saving option is surgery, often removing the affected tube completely.

🌸 The Human Side:

As doctors, we see the heartbreak in women’s eyes when we explain that this pregnancy cannot survive. The pain is not only physical, but deeply emotional — the loss of a much-awaited baby, and the fear for one’s own life.

Yet, when diagnosed early, women recover well and often go on to have healthy future pregnancies. That’s the message of hope we must never forget.

🙏 My message to women in Lusaka and across Zambia:

If you are pregnant and experience unusual abdominal pain or bleeding — please don’t wait. Visit a hospital immediately. Awareness and early action can save your life.

#DrRababCares

 #EctopicPregnancy #WomensHealth #Gynecology #ForestParkHospital #AwarenessSavesLives

Share:

Read More

Supplements during pregnancy

 🌸 Folic Acid & Multivitamins – Building a Healthy Pregnancy 🌸

Pregnancy is a journey that needs more than love and care — it needs the right nutrition 💙.

That’s why supplements like Folic Acid and Multivitamins are essential.

🔹 Folic Acid

Should start before conception and during the first trimester.

Prevents neural tube defects (serious brain and spine problems).

Reduces the risk of cleft lip and certain heart defects.

🔹 Iron

Supports mother’s blood volume which almost doubles during pregnancy.

Prevents anemia, dizziness, and fatigue.

Helps the baby store enough iron for the first 6 months after birth.

🔹 Calcium & Vitamin D

Baby’s bones and teeth need calcium every single day.

Without enough, calcium is taken from the mother’s own bones.

Vitamin D improves absorption and reduces risk of preeclampsia.

🔹 Omega-3 (DHA/EPA)

Supports brain and eye development.

Lowers risk of preterm birth and low birth weight.

🔹 Other Multivitamins

Fill nutritional gaps when diet isn’t enough.

Strengthen immunity, improve energy, and support wellbeing.

✨ Key Reminder:

Every pregnancy is unique. Supplements should always be chosen with a doctor’s guidance — self-medication can be risky.

💙 A balanced diet + guided supplements = a healthier mother and a stronger baby.

🌷 Every mother deserves to start her journey with safety, dignity, and love.

And as doctors, we are here to walk beside you — every step of the way.

#DrRababCares 

#HealthyPregnancy #FolicAcid #Multivitamins #WomenHealth #ForestParkHospital

Share:

Read More

Infantile senses

 😂 Funny Facts

– Baby Knows Best!

During an ultrasound, a mum-to-be asked me:

“Doctor, will my baby recognize your voice when she’s born?”

👶 Fun fact: Babies start developing their senses much earlier than most people think:

Touch begins around 8 weeks — that’s when they can first feel.

Taste develops by 13–15 weeks — yes, they can “taste” flavors through the amniotic fluid!

Hearing becomes active around 25 weeks — and that’s when they start recognizing voices.

So yes, babies know their mum’s voice best, but they can also get familiar with sounds they hear often — including the doctor during checkups!

I smiled and replied:

“Looks like I might need to say hello when she arrives!” 😅✨

And actually, when I deliver babies, I always greet them with a smile and say:

“Welcome to Zambia!” 💙🇿🇲

💡 Key note: Pregnancy is full of miracles — tiny humans growing not only in size but in senses. Science makes the journey even more magical and explains the senses, but love and warmth make the journey unforgettable.

#FunnyFridays

 #DrRababCares

 #ForestParkHospital #WomenHealthMatters

Share:

Read More

Premature rupture of membranes

 💧 Premature Rupture of Membranes (PROM): When “the Water” Breaks Too Soon

👩‍🍼 For Mothers – Awareness

PROM means the water around the baby breaks before labor starts.

If it happens before 37 weeks → PPROM (Preterm PROM).

Warning signs: sudden gush or continuous trickle of fluid, wet underwear, sometimes mixed with blood.

🔔 What to do immediately:

➡️ Don’t wait at home — go to the hospital at once.

➡️ Don’t insert anything vaginally.

➡️ Count your baby’s movements.

➡️ Be alert to fever, abdominal pain, or foul discharge (infection warning).

🧪 How Doctors Confirm PROM

Sometimes it’s not easy to know if the leaking fluid is really amniotic fluid or not.

Doctors may use a quick swab test (like Actim PROM):

Just a simple test done in a few minutes.

Confirms if the fluid is from around the baby.

Helps doctors take the right decision quickly and safely.

🔹 High Leak – Trickle of Fluid

Small tear in the sac → fluid leaks slowly.

Mother may only feel slight wetness.

Still carries risk of infection and preterm labor.

🔹 Low Break – Gush of Fluid

Large tear near the cervix → sudden gush.

More obvious to mother.

After drainage, the risk of accidental hemorrhage increases (placental separation, cord prolapse, maternal bleeding).

⚠️ Why It Matters

PROM isn’t just “waters breaking.”

It can lead to serious complications: 

Maternal infection (chorioamnionitis).

Preterm birth.

Hemorrhage if placenta separates.

Umbilical cord accidents.

🧪 Real-Life Example

A mother at 28 weeks came with fluid leakage.

We did the Actim PROM test ➝ it turned positive ✅.

This confirmed that her water had broken, even though the leakage looked small.

👉 With this clear result, we could act fast: give her steroids, antibiotics, and close monitoring to protect both her and her baby.

🩺 Management Depends on Timing

At term (≥37 weeks): Usually labor is started to reduce infection risk.

Preterm (<37 weeks): 

Steroids to help the baby’s lungs.

Antibiotics to prevent infection.

Careful monitoring for mother and baby.

If infection develops → delivery is necessary.

🌸 Take-Home Message

PROM isn’t just “waters breaking” — it’s a critical moment.

👉 Early recognition + hospital care + quick tests = safer outcomes for mother and baby.

📌 

#DrRababCares 

#WomenHealthMatters #PROM #PregnancyAwareness #ForestParkHospital #LusakaGynae

Share:

Read More

Pregnancy and the brain

 🧠 Pregnancy & the Brain – More Than Science, It’s Sacrifice

Pregnancy doesn’t just change the body — it reshapes the brain. Research shows that during pregnancy, the brain undergoes temporary shrinkage, especially in areas linked to memory and logic. This change is not harmful — it’s an adaptation that helps a mother become more emotionally tuned to her baby. It usually takes around 6 months postpartum for the brain to return to its baseline.

💡 Guidelines & Key Notes:

This is a normal and protective mechanism — not brain damage.

Forgetfulness or emotional sensitivity during pregnancy is often related to these brain changes, combined with hormonal shifts and sleep deprivation.

Support, adequate rest, and good nutrition all play a vital role in recovery.

If severe mood changes, anxiety, or depression persist, medical help should be sought early.

As a gynecologist, I’ve witnessed countless mothers put their baby’s life before their own — sometimes against all logic, guided only by love. It reminds me daily that pregnancy is not simply a medical condition, but a profound emotional journey where science meets sacrifice.

🙏 To every mother: thank you for giving not only your body, but also your mind and spirit, so that new life can continue.

💞 To families and partners: never underestimate the emotional toll of pregnancy. Your patience, encouragement, and support can make the biggest difference in helping mothers feel safe, valued, and strong throughout this extraordinary journey. 👨‍👩‍👧‍👦

#DrRababCares 

#WomenHealthMatters #PregnancyJourney #Motherhood #ForestParkHospital #MaternalHealth #MentalHealthAwareness

Share:

Read More

The power of hystroscopy in modern gynecology

 🧵 The Power of Hysteroscopy in Modern Gynecology

(Real case – Copper IUD embedded in anterior uterine wall)

When an intrauterine device (IUD) migrates or becomes embedded in the uterine wall, it’s no longer just a contraceptive issue — it becomes a surgical challenge.

In this case, a copper IUD was impacted in the anterior uterine muscle wall, causing chronic pelvic pain and bleeding.

 🛑 Attempting blind removal could have led to uterine perforation or incomplete extraction.

🔍 Hysteroscopy made the difference. With direct visualization of the uterine cavity, we safely removed the embedded IUD using a minimally invasive approach — preserving uterine integrity and relieving the patient’s symptoms.

Why Hysteroscopy Matters:

✔️ Diagnostic precision – for polyps, fibroids, adhesions, retained products, and abnormal bleeding.

 ✔️ Therapeutic power – safe removal of IUDs, synechiae, and even resection of intracavitary lesions. 

✔️ Fertility enhancement – essential tool in evaluating and treating uterine factors in infertility. 

✔️ Patient-centered care – often done as day-case with minimal recovery.

👩‍⚕️ In modern gynecology, hysteroscopy isn’t a luxury — it’s a necessity. Empowering us to treat safely, accurately, and compassionately.

🌀 Notice how the IUD appears distorted? That’s the result of prolonged embedding in the anterior uterine wall – a clear example of why hysteroscopic removal is the safest approach.

#DrRababCares 

#Hysteroscopy #GynecologyZambia #IUDComplications #WomenHealthMatters #ForestParkHospital #MinimallyInvasive #LusakaGynae

Share:

Read More

Uterine fibroids and infertility

 🌺 Fibroids & Fertility – What Every Woman Should Know 🌺

Every week, so many women inbox us worried about fibroids and whether they can ever have children. It’s a very real fear — but here’s the truth:

💡 What are Fibroids?

Fibroids are benign (non-cancerous) growths of the uterus. They are very common, especially among women in their 30s and 40s. Most fibroids are harmless, but some can affect fertility and pregnancy.

🔎 How Fibroids Can Affect Fertility

Not all fibroids interfere with getting pregnant. But:

Submucosal fibroids (inside the uterine cavity) can prevent implantation and increase miscarriage risk.

Intramural fibroids (within the uterine wall) — if large — may distort the uterine shape, making it harder to conceive or carry a pregnancy.

Subserosal fibroids (outside the uterus) usually don’t affect fertility, unless they grow very large and press on other organs.

👉 Location and size matter more than the number of fibroids.

🤰 Pregnancy with Fibroids

Many women still conceive naturally with fibroids. However, fibroids can sometimes cause:

Painful or heavy bleeding in pregnancy

Miscarriage

Preterm labor

Malpresentation (baby not turning head down)

Need for cesarean section

⚠️ Important: During pregnancy, fibroids often increase in size due to hormonal changes. This growth can sometimes change their natural structure and lead to acute pain episodes (known as “red degeneration of fibroid”). These attacks can be very distressing but are usually managed with supportive care.

🩺 Treatment Options

1. Observation – If fibroids are small and not affecting fertility or quality of life.

2. Medical therapy – Can help with symptoms (bleeding, pain) but does not shrink fibroids permanently.

3. Myomectomy (fibroid surgery) – Removes fibroids and preserves the uterus. This may improve fertility if the fibroids are inside the cavity or large.

Hysteroscopic myomectomy: for fibroids inside the cavity.

Laparoscopic or open myomectomy: for bigger or multiple fibroids.

✨ Key Takeaway

Fibroids are common — and having them doesn’t mean you can’t get pregnant.

But if you have:

✔️ Multiple miscarriages

✔️ Trouble conceiving for more than 1 year

✔️ Very heavy/painful periods

✔️ Large or multiple fibroids on scan

👉 It’s time to see a specialist. With proper evaluation and treatment, many women go on to have healthy pregnancies.

📩 We received many inbox questions about fibroids and fertility. If this is your concern too, remember: you are not alone, and solutions are available.

#DrRababCares #FibroidsAwareness #WomensHealth #FertilityJourney #ObGyn #FibroidsAndFertility #UterineHealth #LusakaDoctors #ForestParkHospital #HealthEducation #WomensCare #FertilityAwareness

Share:

Read More

Retroverted uterus

 🔹 Retroverted Uterus (Tipped Uterus)

(Shifted womb)

Normally, the uterus tilts slightly forward. In some women, the uterus tilts backward toward the spine — this is called a retroverted uterus.

🔬 Key Facts:

Present in about 20–25% of women.

Often a normal anatomical variation.

Can be congenital (born with it) or acquired (after childbirth, surgery, or pelvic conditions like endometriosis).

🌸 Symptoms (if any):

Most women have no symptoms at all.

Some may experience: 

Lower back pain during menstruation.

Pain during intercourse.

Urinary frequency or discomfort (rare).

🤰 Fertility & Pregnancy:

Does NOT usually affect fertility.

In pregnancy, the uterus naturally rises as it grows — so in most cases, the retroversion corrects itself by the second trimester.

Rarely, it can lead to a condition called uterine incarceration, when the uterus becomes “trapped” in the pelvis around 12–14 weeks of pregnancy. 

Symptoms: difficulty urinating, constipation, pelvic pain, or pressure.

Diagnosis is made by ultrasound.

Usually corrected with simple measures (like positional exercises); rarely, medical intervention is needed.

🩺 Why Knowing the Uterine Position Matters

Understanding whether the uterus is anteverted or retroverted is important during pelvic exams and procedures. For example, during IUD insertion, knowing the uterine position ensures:

Smooth and safe insertion.

Less discomfort for the patient.

Reduced risk of complications.

💙 A retroverted uterus is not a disease — it’s a normal variation. What matters most is reassurance, early diagnosis, and proper assessment during pregnancy and gynecological procedures.

#DrRababCares

#WomenHealth #OBGYN #Uterus #PregnancyAwareness #IUD #ForestParkHospital #Lusaka

Share:

Read More

Recurrent first trimester miscarriage

 🌸

Recurrent First-Trimester Miscarriage

Losing a pregnancy, especially in the first trimester, is one of the most painful experiences for any woman or couple. When this happens more than once, it becomes even more devastating — and is medically defined as recurrent miscarriage.

🔹 Traditionally, this meant 3 or more consecutive losses before 12 weeks, but today, most guidelines (ASRM / RCOG) recommend starting investigations after 2 consecutive losses.

🔍 Common Causes

Genetic factors: Chromosomal abnormalities in the fetus (the most common cause).

Anatomical: Uterine anomalies (septate uterus, fibroids, adhesions).

Endocrine: Poorly controlled diabetes, thyroid disorders, PCOS with insulin resistance.

Immunological/Thrombophilia: Antiphospholipid syndrome (APS), inherited clotting disorders.

Lifestyle: Smoking, alcohol, obesity, excessive caffeine.

Infections: Rare, but sometimes considered.

Age : advanced maternal age.

🧪 Recommended Investigations

Karyotyping (parents or products of conception if possible).

3D ultrasound / hysteroscopy for uterine assessment.

Screening for APS (anticardiolipin, lupus anticoagulant, β2-glycoprotein).

Thyroid function, HbA1c.

Optional: thrombophilia screen (case-by-case).

💊 Management Options

Preconception care: Optimize weight, control diabetes/thyroid.

APS confirmed → Low-dose aspirin + LMWH during pregnancy.

Uterine anomalies → Surgical correction (e.g., hysteroscopic septum resection).

Genetic causes → Sometimes miscarriages happen due to repeated chromosomal issues. In these cases, doctors may recommend IVF with advanced embryo testing (Preimplantation Genetic Testing, PGT). This means embryos are checked in the lab before being transferred to the womb, so that only healthy ones are chosen — reducing the risk of miscarriage.

Emotional support & close monitoring — proven to improve pregnancy outcomes.

💡 Key Message

Not every recurrent miscarriage has a clear cause — up to 50% remain unexplained. But with thorough evaluation, lifestyle optimization, and compassionate follow-up, most women can go on to have a healthy pregnancy. 💙

#DrRababCares — 

because every woman deserves hope, answers, and support on her journey.

#WomensHealth #MiscarriageAwareness #FertilityCare #DrRababCares #ForestParkHospital

Share:

Read More

The psychological factor in complex obstetric Surgeries

 🔹 The Psychological Factor in Complex Obstetric Surgeries

In obstetrics, we often emphasize surgical protocols, blood transfusion strategies, and technical expertise. These are vital, but they are not the whole picture.

What we rarely highlight is the psychological factor of the surgeon — the ability to remain calm, focused, and decisive under extreme pressure.

🧠 Why the Psychological Factor Matters

1️⃣ Time Pressure – Seconds can decide life or death.

2️⃣ Dual Responsibility – The surgeon carries the weight of both mother and baby.

3️⃣ Leadership Under Stress – The team relies on the surgeon’s direction.

4️⃣ Emotional Impact – Stillbirth, hemorrhage, or maternal collapse test emotional endurance.

5️⃣ Burnout & Resilience – Fatigue and stress can cloud judgment if not controlled.

Obstetric surgery doesn’t just test hands — it tests the mind and spirit.

🌸 A Real Example

A young woman came in active stage of labor, with severe abdominal pain and a distended abdomen. Ultrasound confirmed intrauterine fetal demise with a large retroplacental hematoma (~11cm).

Her platelets dropped rapidly — she was already slipping into HELLP syndrome. The dilemma was clear:

➡️ Wait for natural labor?

➡️ Or act immediately to save her life?

There was no time for hesitation. We rushed her to the operating theater.

Inside, we found:

Massive concealed hemorrhage (~1500 ml)

A bruised, blue uterus — Couvelaire uterus

The baby was already lost. The fight was now to save the mother. We controlled the bleeding, preserved her uterus, and admitted her to ICU.

She later developed eclampsia, but with magnesium sulfate and intensive care, she improved.

✨ Days later, she walked out alive, on her feet, with her uterus intact.

🌱 Reflection

This case reminded me that complex obstetric surgery is not only a technical battle — it is a psychological one.

Strong hands may stop bleeding.

But only a strong, resilient mind can carry a surgeon through chaos, lead a team with clarity, and give a mother the chance to walk out alive.

📖 As the Royal College of Obstetricians and Gynaecologists reminds us: “The wellbeing of doctors is patient safety. Fatigue, stress, and burnout impair clinical judgment and increase the risk of adverse outcomes.”

#DrRababCares 

#Obstetrics #Surgery #HELLPSyndrome #PsychologicalResilience #WomenHealthMatters #OBGYN #LusakaGynae

#ForestParkHospital

Share:

Read More

Induction of labour

 🟡 To Every Mama Facing Induction of labour: You’re Not Alone

Many women write to me feeling anxious about being induced — especially those with diabetes or other medical concerns.

One heartfelt message said:

> “Please explain labour induction. I’m diabetic. They want to induce me. Everyone is giving me information that’s stressing me for days. I’m sure others feel like me.”

💛 You are not alone. And this post is for you — and every woman walking this path.

🧠 What Is Labour Induction?

Labour induction means starting contractions artificially, before they begin on their own. This can be done using:

Medications (e.g., prostaglandins or oxytocin)

Or mechanical methods (e.g., Foley catheter or rupturing the membranes)

🩺 Why Is Induction Recommended?

Doctors may recommend induction when continuing the pregnancy becomes riskier than delivering, such as in cases of:

Diabetes (gestational or pre-existing)

High blood pressure or preeclampsia

Low amniotic fluid

Post-term pregnancy (after 41 weeks)

Reduced fetal movement or placental insufficiency

In these situations, induction can be a life-saving decision — for both the mother and the baby.

⚠️ One Key Risk: Shoulder Dystocia

In diabetic pregnancies, babies may grow larger than average, especially in the shoulders and upper body — a condition called macrosomia.

This increases the risk of a serious complication:

🧨 Shoulder Dystocia — when the baby’s head delivers but the shoulders become stuck behind the pelvic bone.

It’s a true obstetric emergency, and it requires:

Skilled medical staff

Quick, precise maneuvers

A well-prepared hospital

This is why fetal weight estimation and birth planning are critical — especially in diabetic mothers.

🩺 Induction in Diabetic Mothers: What You Should Know

If you’re diabetic, your doctor might suggest induction around 38–39 weeks to avoid risks like:

Stillbirth (IUFD)

Placental aging or insufficiency

Macrosomia and shoulder dystocia

But it must be individualized:

Know your baby’s estimated weight

Ask about your Bishop score to assess cervical readiness

Keep your blood sugar well controlled

Choose a hospital with continuous monitoring and surgical backup

💡 If the baby is estimated to weigh >4.0–4.5 kg, a planned C-section may be safer.

📋 What Do the Guidelines Say?

According to ACOG and NICE guidelines:

Induction is safe around 38–40 weeks for high-risk pregnancies

Bishop Score helps determine the right method

The hospital must be equipped for emergency delivery if needed

CTG monitoring during induction is essential

💬 Final Words

Induction isn’t something to fear — it’s just a medical tool.

When used wisely and in the right setting, it can save lives and ensure safe outcomes.

You don’t need to feel pressured or overwhelmed.

You just need to feel informed and supported.

🤍 And I promise to keep sharing — for you, and for every woman who needs clarity, not confusion.

#DrRababCares 

#LabourInduction #DiabeticPregnancy #SafeDelivery #WomenHealthMatters #ForestParkHospital #ObGynZambia #HighRiskPregnancy #PregnancyEducation #EmpoweredMothers #ShoulderDystocia

---

Share:

Read More

VBAC conditions before it can even be considered

 ⚠️ VBAC – Conditions Before It Can Even Be Considered

After a cesarean, many women ask:

“Can I try to deliver naturally next time?”

This is called VBAC (Vaginal Birth After Cesarean).

💡 VBAC is not suitable for everyone.

For a woman to even attempt VBAC, several conditions must be met:

1. Type of scar – Only a low transverse scar is considered safe enough; vertical scars are too risky.

2. Number of previous C-sections – Usually one scar; more than one increases the risk significantly.

3. No major complications – No placenta previa, no big fibroids, no previous uterine rupture.

4. Baby’s position – Head down, normal presentation.

5. Hospital readiness – A fully equipped operating theater and a surgical team must be available for emergency C-section at any time.

⚠️ Even with these conditions, the risk of uterine rupture or severe tears is real. Some mothers may pass through safely, but others face dangerous complications — like cervical tears or heavy bleeding.

Or Uterine rupture

In many cases, a planned repeat cesarean is the safer choice.

📊 Numbers to Keep in Mind:

Success rate: 70–75% (when strict conditions are met).

Risk of uterine rupture: 0.5–1% (around 1 in every 200–250 attempts).

Emergency C-section conversion: 20–30% of women attempting VBAC may need urgent surgery.

🔖 Support & Message to Women:

If your doctor advises against VBAC, it’s out of care for your safety.

Choosing a repeat cesarean is not failure — it’s choosing life and protection for yourself and your baby.

You are strong, brave, and complete — no matter how your baby is born.

👩‍⚕️ Final advice:

Always talk openly with your doctor. Ask about your scar type, your risks, and whether your hospital is prepared for VBAC. Every pregnancy is unique — and the safest plan is always the best plan. 💙

#DrRababCares 

#SafeMotherhood #CesareanDelivery #VBAC #WomenHealthMatters #ForestParkHospital #GynecologyZambia

Share:

Read More