Behind every tiny cry in the NICU lies a story of strength, patience, and pure miracles.  

A baby born too soon isn’t weak — they’re a little fighter learning to breathe, grow, and love the world one heartbeat at a time.  

Every extra day inside the womb, every minute of care in the incubator, every mother’s touch matters deeply. 

Because every tiny baby deserves a big chance.

Every breath, every heartbeat, every cuddle — counts. 💜  

What Is Preterm Labour

Preterm labour means the onset of uterine contractions and cervical changes before 37 weeks of pregnancy.  

The earlier it happens, the higher the risks — but with timely medical care, outcomes can greatly improve.  

 Common Causes

- Previous preterm birth  

- Cervical weakness or short cervix  

- Twin or multiple pregnancy  

- Infections (especially vaginal or urinary)  

- Placental problems (abruption, previa)  

- Maternal factors such as stress, smoking, or uncontrolled diabetes/hypertension  

Early Warning Signs

- Regular contractions or abdominal tightening before 37 weeks  

- Pelvic pressure or low back pain  

- Watery or bloody vaginal discharge  

- Leaking fluid (possible membrane rupture)  

- Decreased fetal movements  

If you notice any of these don’t wait.

Early hospital assessment can stop or delay labour and protect your baby’s life.

Prevention & Care

- Regular antenatal check-ups  

- Screening and treating infections  

- Cervical cerclage or progesterone support when needed  

- Adequate rest, hydration, and nutrition  

- Hospital monitoring and steroid therapy for fetal lung maturity  

Dr Raban And Forest Park Specialised Hospital, we stand with every mother and every preemie — because tiny babies deserve extraordinary care.

As an obstetrician, I’ve witnessed how every minute can change a baby’s future.Dr Rabab Mustafa

#DrRababCares #WorldPrematurityDay #PretermLabour #MaternalHealth #NeonatalCare #ForestParkHospital #Zambia #WomenHealth #Motherhood #Hope

 💛 Doctors Are Human Too

Being a doctor doesn’t mean being available 24 hours a day.

We get tired.  

We need rest.  

We have families, homes, sleep, and a life outside the hospital.

Sharing my number with a patient is an act of trust 

not an invitation to call at midnight for non-urgent issues,  

and not a permission to cross personal boundaries.

If someone has been unwell for hours, it’s unfair to wait until 12 AM to call the doctor  and then refuse to visit the hospital. 

What meaningful medical help can be given over the phone at that time?

Respect goes both ways.

Every physician deserves:

• Clear working hours  

• Resting time  

• Privacy  

• And the basic courtesy of being contacted at reasonable hours  unless it's a true emergency

Being reachable does not mean being on call for the whole world.

Let’s remember: doctors are humans, not machines.  

Respecting a doctor’s boundaries is part of respecting their care.

💛 Dr Rabab Cares

#DrRababCares

 Scientific Fact Friday

Did you know that your feet can actually get bigger during pregnancy?

This is a completely normal physiological change that happens to many women.

🧠 Why does this happen?

- The hormone “Relaxin” loosens the ligaments in the feet, causing the arch to flatten.

- Increased body weight adds more pressure on the foot, making it slightly longer or wider.

- Fluid retention during pregnancy can make shoes feel tight or uncomfortable.

- Changes in posture and gait shift pressure on different parts of the foot.

📌 When does it usually start?

It can begin in the second trimester and become more noticeable in the third trimester.

📌 Is it permanent?

About 60% of women keep a slightly bigger shoe size even after delivery. 

For others, the size partially returns to normal.

🦶 What can help?

- Supportive, comfortable shoes  

- Avoid very flat or thin soles  

- Elevate your feet when possible  

- Gentle stretching  

- Consider maternity-friendly footwear

⚠️ When to seek medical review?

- Severe swelling

- Swelling in one foot only

- Pain with redness

- Shortness of breath or sudden swelling (red flag)

Pregnancy: even your shoes might need a maternity upgrade! 😅👟🤰

#FunnyFridays  

#DrRababCares  

#PregnancyFacts  

#WomenHealth  

#MotherhoodJourney  

#PregnancyChanges  

#OBGYNTips  

#PregnantLife  

#MaternityCare  

#LusakaMoms  

#ForestParkHospital  

#ZambiaHealth

 Family Planning Series – Week 8:

( Injectable Contraceptives )

 What are Injectable Contraceptives?

They are hormonal birth-control injections that prevent ovulation and thicken cervical mucus, making it harder for sperm to reach the egg.  

The most common types are:  

• Depo-Provera  150 mg Medroxyprogesterone acetate | IM | Every 3 months (13 weeks)
• Sayana Press  104 mg Medroxyprogesterone acetate | SC | Every 3 months (13 weeks) 
• Noristerat 200 mg Norethisterone enanthate  IM | Every 2 months.

How They Work ?

1️⃣ Inhibit ovulation.  

2️⃣ Thicken cervical mucus to block sperm.  

3️⃣ Thin the uterine lining to prevent implantation.  

Advantages :

✅ Very effective (97–99% if taken on time).  

✅ Long-acting and reversible.  

✅ Safe for breastfeeding (after 6 weeks postpartum).  

✅ Can reduce menstrual pain and bleeding.  

✅ Suitable for women who can’t take estrogen.  

⚠️ Possible Side Effects:

- Irregular bleeding or no periods.  

- Mild weight gain or bloating.  

- Headache or mood changes.  

- Delayed fertility return (4–10 months) after last dose.  

- Slight bone density reduction if used for more than 2 years.  

- Does not protect against HIV or STIs.

 📋 Guideline Notes (WHO & ACOG):

- Start within first 7 days of menstruation or 6 weeks postpartum.  

- Keep injections on schedule (every 8–13 weeks depending on type).  

- If > 2 weeks late → rule out pregnancy before reinjection.  

- Regular BP check and counseling about delayed fertility are essential.  

💬 Key Message :

Injectables are safe, effective, and convenient — but timing and follow-up are everything.  

They don’t protect against STIs, so condoms are still important for protection.  

#DrRababCares

 #FamilyPlanning #Injectables #DepoProvera #Noristerat #SayanaPress #Contraception #ReproductiveHealth #WomensHealth #OBGYN #Lusaka #ForestParkHospital

 💛 To Every Mother Who Has Lost a Child

There are no words deep enough for such pain.

No time that truly heals it,

and no heart that ever forgets.

Dear mother  your grief is sacred.

You are not weak for crying,

you are human for loving so deeply. 🤍

You carried life, and love, and hope.

And though your arms may feel empty,

your heart still beats with his farewell. 

Please remember 

your motherhood didn’t end with goodbye.

It simply changed shape,

and now it lives in every heartbeat of love that remains.

اللهم اربط على قلب كل أم فقدت طفلها،

واملأ أيامها بالصبر الجميل والسكينة التي لا تزول. 🤍

 Farewell, Little Olive ❤❤

Some souls are too pure, too brave,

to stay long in this world.

Little Olive fought with a courage far beyond his years,

with eyes full of light,

and a smile that made pain look small. 

Now heaven embraces him —

no tubes, no tears, no fear —

only peace, and light, and eternal rest. 🤍

To his mother, and to every mother who has walked this road —

your love has not ended,

it has simply crossed into a place

where angels hold what you once held.

> اللهم اجعله من طيور الجنة،

وارزق أمه الصبر الجميل،

واجعل لقلبها نورًا ورحمةً لا تنطفئ. 🤍

With compassion and prayers,

Dr Rabab Cares

 Not Every Breast Pain Means Something Serious

Many women visit their gynecologist because of breast pain or a small lump —and that’s okay, because most women trust their OB-GYN first.

But here’s the truth:

 the breast is actually a surgical organ.

Your gynecologist’s role is to listen, examine, and guide you to the right specialist when needed. 

Most Common (and Usually Benign) Reasons for Breast Pain or Lumps

 Hormonal changes (Fibroadenosis / Fibrocystic changes)

– Common before the period.

– The breast feels tender or slightly swollen, then returns to normal afterward.

 What helps: a supportive bra, reducing caffeine and salty foods, and simple pain relief if needed.

Fibroadenoma

– A soft, mobile lump under the skin.

– Usually benign, but should be confirmed with an ultrasound.

 Mastitis or Abscess

– More common while breastfeeding.

– The breast becomes red, warm, painful ± fever.

– Needs medical evaluation and antibiotics or drainage if required.

 See a Doctor Immediately If You Notice:

• A hard or fixed lump
• Bloody nipple discharge
• Skin or nipple retraction
• Swelling under the arm

💛 The Takeaway:

Not every breast symptom means cancer  but every change deserves attention.

Start with your gynecologist, and follow up with a breast surgeon if needed.

Early care saves lives. 🤍

📸 Attached below:

A simple visual guide for Breast Self Examination —

Because awareness starts with knowing your own body. 

#DrRababCares 

#WomenHealth #BreastAwareness #SelfExamination #Gynecology #LusakaDoctors #EmpathyInMedicine

 Pelvic Inflammatory Disease  The Silent Damage 

Pelvic Inflammatory Disease (PID) is one of the most common  yet often overlooked  causes of chronic pelvic pain and infertility in women.

🔹 What it is:

PID is an infection of the female reproductive organs — mainly the uterus, fallopian tubes, and ovaries — usually caused by sexually transmitted bacteria like Chlamydia or Gonorrhea.

🔹 How it happens:

It often begins as a lower genital infection that spreads upward to the upper reproductive tract — especially when left untreated or self-medicated.

🔹 Symptoms to watch for:

• Lower abdominal or pelvic pain
• Abnormal vaginal discharge (with odor or color changes)
• Pain during intercourse
• Irregular bleeding
• Fever or chills
• Sometimes, symptoms are mild or even silent — which makes early diagnosis crucial.

🔹 Long-term risks:

• al damage leading to infertility
• Ectopic pregnancy (tubal pregnancy)
• Chronic pelvic painTub

🔹 Prevention & Care:

• Regular screening for STIs
• Seeking medical care promptly after any pelvic infection
• Avoiding self-medication or delayed treatment
• Using protection when needed
• Partner evaluation and treatment when indicated
• Remember: PID can start quietly but leave a lifetime impact.
• Early detection saves future fertility — and your health is worth that attention.

#DrRababCares 

#WomenHealth #PID #PelvicPain #ReproductiveHealth #STIawareness #InfertilityPrevention  #ObGyn

 That moment when your pregnancy walk turns into a cute little waddle 🐧

It’s not clumsiness — it’s your body’s smart way of keeping balance while carrying precious cargo 🤰.

Your hips shift, your belly leads the way, and suddenly every hallway feels like a mini catwalk! 👣

Some call it the ‘penguin walk’ — we call it the Super-Mama stride! 

This gentle waddle happens because your body is preparing for delivery: the hormone relaxin loosens your ligaments, your center of gravity changes, and your pelvis tilts slightly to make space for your growing baby.

So yes — you’re not clumsy… you’re just evolving beautifully into motherhood ❤️.

🌸 Guidelines – Coping with “The Waddle Walk”

• Keep moving! 🚶‍♀️ Gentle walks maintain blood flow and reduce swelling.
• Wear comfy shoes 👟— support matters more than style.
• Prenatal yoga or stretching helps relieve pelvic pressure and improves posture.
• Avoid standing too long; take short breaks to rest your legs.
• Sleep with a pillow between your knees 🛏️ to align hips and reduce back strain.

If waddling becomes painful, check with your OB/GYN — sometimes it’s due to pelvic girdle pain, which needs special support.

 Pregnancy: turning every hallway into a slow-motion runway… with the world’s cutest walk! 😄💃

#FunnyFridays #DrRababCares

 #PregnancyJourney #WaddleWalk #ForestParkHospital

 Family Planning Series – Week 7:

 Vasectomy (Male Sterilization)

🔹 What is Vasectomy?

Vasectomy is a permanent method of contraception for men.  

It involves cutting or sealing the vas deferens, the tubes that carry sperm from the testicles to the urethra, preventing sperm from mixing with semen.  

It is a minor surgical procedure , usually done under local anesthesia, and takes about 15–30 minutes.  

📋 Indications

•  Men who have completed their families.  
•  When pregnancy may endanger the woman’s health (e.g., cardiac disease, hypertension, diabetes).  
•  When couples desire a simple, permanent method.  
•  When other contraceptive methods are unsuitable or have failed.  
•  When both partners agree after good counseling that the man will take responsibility for contraception.  

⚙️ How it works

• The procedure blocks the vas deferens on both sides — either by ligation, cauterization, or clips.  
• Semen is still produced, but it contains no sperm, so pregnancy cannot occur.  
• It does not affect hormones, sexual desire, or the ability to have an erection.  

 🌟 Advantages

✅ Permanent and highly effective (>99%).

✅ Simple outpatient procedure.  

✅ No effect on libido or testosterone.  

✅ Safe, low-risk, and cost-effective in the long term.  

✅ Allows shared family planning responsibility between partners.  

 ⚠️ Disadvantages / Possible Side Effects

- Requires minor surgery.  

- Discomfort, bruising, or swelling for a few days after the procedure.  

- Rare complications (infection, hematoma, chronic pain).  

- Takes about 3 months or 20 ejaculations for sperm to clear completely — another contraceptive method must be used until semen analysis confirms azoospermia.  

- Permanent – reversal is difficult and not always successful.  

- Does not protect against HIV or other STIs.  

📖 Guideline Notes (WHO & CDC)

- Pre-operative counseling is essential for both partners.  

- Written informed consent must be obtained.  

- Post-operative semen testing should confirm the success of the procedure before stopping other contraceptive methods.  

- Men should be informed that vasectomy is a permanent choice.  

💡 Key Message

Vasectomy is a safe, permanent, and reliable method of contraception for men who have completed their families.  

It does not affect sexual function, but requires good counseling for both partners before the decision.  

#DrRababCares

 #FamilyPlanning #Vasectomy #MaleSterilization #WomensHealth #ForestParkHospital #Lusaka #OBGYN #Contraception #ReproductiveHealth

 Hepatitis B in Pregnancy — Updated Guideline 2024 / 2025 

1️⃣ Screening (According to ACOG & CDC)

• Every pregnant woman should be screened for HBsAg at the first antenatal visit, regardless of vaccination history.  
• If HBsAg positive → check:  
•  HBV DNA(viral load)  
•   HBeAg
•  Liver function tests: ALT, AST, bilirubin, ALP, albumin, INR  
•   Renal function:urea, creatinine, eGFR (Tenofovir is renally excreted).  
•  If HBsAg negative but at risk → vaccinate during pregnancy (safe in all trimesters).  

2️⃣ Assessing Severity & Baseline Work-up

•  Normal LFTs + low viral load (< 200,000 IU/mL) → usually no antiviral ; follow up every trimester.  
•  Elevated LFTs or high viral load (≥ 200,000 IU/mL) → initiate antiviral prophylaxis.  
•  Screen for co-infections(Hepatitis C, HIV).  
•  Assess fibrosis if chronic infection (Fibroscan / FIB-4 if available).  

3️⃣ Antiviral Therapy (AASLD 2023 / WHO 2024)

- Drug of choice:Tenofovir Disoproxil Fumarate (TDF) 300 mg daily

  - Start at 28–32 weeks gestation if:  

    - HBV DNA > 200,000 IU/mL, or  

    - HBeAg positive with high transmission risk.  

  - Continue until delivery or up to 12 weeks postpartum(to prevent flare).  

- Do NOT start antivirals if viral load < 200,000 IU/mL with normal LFTs.  

- Monitor  renal & hepatic function every 4–6 weeks while on Tenofovir.  

4️⃣ Delivery & Intrapartum Management

•  Cesarean section not recommended solely for HBV prevention.  
•  Avoid: prolonged rupture of membranes & invasive procedures (e.g., fetal scalp sampling).  
•  Inform the delivery team of maternal HBV status and newborn prophylaxis plan.  

 5️⃣ Neonatal Prophylaxis (CDC / WHO)

- Within 12 hours after birth, each infant born to an HBsAg-positive mother must receive:  

  1. Hepatitis B vaccine (birth dose) 

  2. Hepatitis B immune globulin (HBIG) — in a separate site.  

- Complete 3-dose vaccine series at 0 – 1 – 6 months.  

- Follow-up serology at 9–12 months:  

  - anti-HBs > 10 mIU/mL + HBsAg negative → protected.

  - HBsAg positive → refer for specialist care.  

6️⃣ Postpartum & Breastfeeding

- Breastfeeding is safe if the baby received vaccine + HBIG.  

- Continue Tenofovir if indicated for maternal liver disease.  

- Re-check maternal LFTs 6–12 weeks postpartum for possible flare.  

 7️⃣ Patient Education Points

💬 Hepatitis B doesn’t mean you can’t have a healthy baby

- Early testing = early protection.  

- Antivirals are safe in pregnancy.  

- Baby’s birth-dose + HBIG = life-saving combo.  

- HBV vaccine is safe during pregnancy for women at risk.  

#DrRababCares 

#HepatitisB #PregnancyCare #WomenHealth #ForestParkHospital #Lusaka #ObGyn #MaternalHealth #HepatitisBGuidelines #PublicHealth #WHO #CDC #AASLD #ACOG

 Tubal Miscarriage – When an Ectopic Pregnancy Ends on Its Own

• Sometimes, a pregnancy starts in the wrong place — inside the fallopian tube instead of the uterus.
• In some cases, the pregnancy tissue detaches and passes out through the tube before it ruptures.
• This is called a tubal miscarriage (or tubal abortion).

💬 What women should know:

• It can cause one-sided pelvic pain and light vaginal bleeding.
• The pain may come and go — and sometimes it feels like period cramps.
• You might think it’s a miscarriage, but in fact the pregnancy was outside the uterus.
• If left unnoticed, it can still cause internal bleeding — so early medical review is essential.

Always seek care if:

You have delayed period, positive pregnancy test, and pain on one side.

You feel dizzy, weak, or notice unusual spotting.

🩺 Medical insight / Guidelines:

According to RCOG & ACOG guidelines:

• β-hCG trend helps identify the pattern: it usually rises slowly or starts to fall.
• Transvaginal ultrasound is essential to confirm there is no intrauterine sac.
• If the patient is stable and the hCG is declining, expectant management (observation) can be safe.
• If pain worsens or hCG fails to drop, methotrexate or laparoscopy should be considered.

🌿 Dr Rabab Cares Message:

Sometimes, your body ends what it cannot safely continue —

and that’s not your fault.

Understanding what’s happening early can save your fertility and your life.

Always listen to your body and never ignore one-sided pain or unusual bleeding.

#DrRababCares 

#EctopicPregnancy #TubalMiscarriage #WomenHealth #LusakaDoctors #ForestParkHospital #EarlyDiagnosisSavesLives

 Maternal Mortality — A Painful Reality We Must Keep Talking About

As an obstetrician, I’ve learned that maternal mortality is one of the hardest truths in our field.

Even with 5-star care, advanced facilities, and a highly skilled team, a mother’s life can still be lost in rare and tragic circumstances. This is not about one hospital or one doctor—it’s a global challenge.

Most maternal deaths are preventable. The leading causes include:

• Severe bleeding (PPH)

• Hypertensive disorders (eclampsia/preeclampsia)

• Infections (sepsis)

• Complications during delivery or surgery

• Anaemia and indirect causes (e.g., HIV, TB, malaria)

🌿 How we can reduce the risks:

•  Early and regular antenatal care to detect anaemia, hypertension, diabetes, etc.
• Timely referral and delivery in well-equipped facilities
•  Reliable access to emergency blood
•  products and a functional referral/transport system
•  Continuous training and drills for obstetric emergencies (PPH, eclampsia, sepsis)
•  Community awareness of danger signs and seeking care early

Let’s remember: maternal death doesn’t always mean there was neglect. Sometimes, despite doing everything right, complications move faster than medicine can respond. Still, we must keep improving, learning, and supporting one another—because every mother matters. 🤍

#DrRababCares

 #MaternalHealth #WomensHealth #Obstetrics #GlobalHealth #PatientSafety #Zambia