Find, gather and cook wild plants with urban forager Lisa M. Rose | CNN

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Come spring, avid gardeners dig into the new growing season ready with careful cultivation plans they dreamed up over long winters. But even city-dwelling non-planners can benefit from year-round botanical bounty. They just need to learn what, where and how to harvest the wild foods growing in lawns, parks and scrubby backlots.

Chickweed, dandelion and dock provide delicious, nutrient-rich greens, while daylilies, lilacs, honeysuckle and roses can add floral overtones to syrups, jellies and baked goods. Protein-packed wild plants and plant parts include purslane, acorns and brown dock seeds. Teas and tinctures made from ground ivy, gingko and golden rod, along with many other “weeds” and invasive species, can serve various medicinal purposes, once properly prepared.

In her book “Urban Foraging: Find, Gather, and Cook 50 Wild Plants,” herbalist and expert forager Lisa M. Rose offers guidance on safely identifying, gathering and preparing edible flora that grow wild in most major US cities.

“Gathering your own food to make dinner can help instill a sense of place,” she said. She maintains that highlighting the role of wild plants in our food system can teach us to heal our soil, our waterways and our own public health. In this way, urban foraging creates new potential for greener, healthier and more sustainable ecosystems.

This conversation has been edited and condensed for clarity.

CNN: What makes you so passionate about urban foraging?

Lisa M. Rose: “Oh my gosh, you can EAT those?” pretty much sums up the thrill of urban foraging. Showing people all the edible plants that grow in cities helps connect them with the natural world.

It’s revolutionary to think differently of the unloved weeds and see opportunity in the neglected spaces that people pass by. The most fun, engaging thing is to get back outside and reconnect with the happiness that a dandelion flower can bring. Reinhabiting our 8-year-old, judgment-free selves allows us to recognize an elemental, earthly kind of beauty without the preconceived notions.

Plus, wild plants have a unique function in the ecosystem. Even so-called invasive species can remediate the soil and water. They help to repair areas that have been leveled and left open to erosion by creating a structure that keeps the soil from blowing away. Soil is the building block of human health, and it needs a rich, diverse base of organic material to be able to give us nutritious food.

CNN: What safety precautions do you recommend for people foraging in cities?

Rose: My family is from Flint, Michigan. I take soil and water contamination issues very seriously. The first steps to safe urban foraging are knowing where to harvest — including researching the history of the land, if possible — and learning which plants and plant parts may be more likely to contain contaminants like heavy metals or pollutants.

Nettles, for example, are apt to take up heavy metals like lead. So, I recommend harvesting these only from places free of soil contamination. The key is to take caution and be judicious. But remember, given the realities of our industrialized food system, the plants available at a commercial supermarket often have layers of pesticides. We don’t live in a perfect world.

Also, it sounds silly, but when it comes to plants or mushrooms, if you don’t know what it is, don’t pick it, and definitely don’t put it in your mouth!

CNN: What does it mean to forage responsibly? How can we take from while taking care of the land?

Rose: As you observe an environment and learn what plants could be edible, make the effort to learn further: Is this endangered? Threatened? An invasive species? We want to consider, ethically, the plant’s distribution and the habitat.

I rarely feel badly when I pick my garlic mustard. It’s going to come back. But when it comes to foraging by greengrocers and restaurants, it’s important to consider that there’s only so much the ecosystems can offer at that retail level. Where are these items coming from? How do I ensure no habitat destruction happens under the name of foraging trends? We have a long way to go in creating regionally based food systems that would help all of us, including our restaurants and grocers.

CNN: How do community health and food justice concerns fit into foraging?

Rose: It’s impossible to decouple social justice from human health. Food-system inequities have a massive impact on access to nutrients and effects on human health.

About 10% of the US population faces food insecurity — a wicked problem that foraging, gardening and local food systems cannot solve alone. But, restoring foodways — even simply refining how to cook basic things — can play a powerful part in increasing food access. Urban foraging is an effort to democratize the wild plants to make them more available to more people. You don’t have to be classically trained as a botanist at university. These are basic human skills.

CNN: How much could we rely on urban foraging to feed ourselves?

Rose: Not significantly, given the current populations and designs of our cities. It’s inconceivable and unethical for me to suggest that all of Manhattan go and use Central Park as their greengrocer. But intentionally designing more green space can create the possibility for more available food for city communities within a smaller footprint.

CNN: Can you forage year-round?

Rose: Yes! Harvesting must be done in context of your growing zone, of course, but part of the endeavor is to recognize what your landscape can provide. Even on frigid January and February days, foragers can find bark, buds and sap. Consider how, for millennia, indigenous communities supported a basic diet with fresh and stored wild foods. In many traditions, for example, acorns — high in carbohydrates and protein — played a significant role in helping to extend harvests to provide food for the winter.

Acorns are a quintessential forager’s food that can be used in soups, pulverized into a nut butter or ground into flour for baking. Every fall, I process enough acorns to make 10 to 15 pounds of flour, with the help of neighbors who drop off bags full or team up to shell them while we chat over cocktails and cheese. Later, we share the acorn bread I bake, which is kind of my signature.

Recipe: Acorn Bread

Makes 1 loaf

Ingredients

  • 1 cup processed acorn flour (see how to make below)
  • 1 cup all-purpose or gluten-free flour
  • 1 teaspoon baking soda
  • 1/4 teaspoon salt
  • 1/2 cup unsalted butter
  • 3/4 cup brown sugar
  • 2 medium eggs, beaten
  • 2 1/3 cups mashed overripe bananas
  • 1-2 tablespoons cocoa powder, if desired
  • Additional butter or nonstick spray to grease pan

Instructions

Prepare the flour

  1. Shell enough fresh acorns to get about 2 cups of acorn nutmeats. Roughly 2 cups of dry acorn nutmeats will grind into 1 cup of nut flour.
  2. Add about 2 cups of acorn nutmeats to a large pot of water. Bring to a boil, let cook for 10 minutes and then strain.
  3. Allow nutmeats to cool. Then, using a dehydrator or oven, slowly dry the nutmeats over low heat.
  4. Once completely dry, grind the nutmeats with a coffee grinder or mortar and pestle to reach the texture of a flour.
  5. Store acorn flour in the freezer for up to 6 months.

Bake the bread

  1. Preheat the oven to 350 degrees Fahrenheit.
  2. Using butter, coconut oil or a non-stick spray, lightly grease a 9×5-inch loaf pan.
  3. In a large bowl, combine the flours, baking soda and salt.
  4. In a separate bowl, cream together butter and brown sugar. Stir in eggs and mashed bananas until well blended. Stir banana mixture into flour mixture.
  5. Pour batter into the prepared loaf pan. Bake for one hour or until a toothpick inserted into the center of the loaf comes out clean. Remove from oven and let the bread cool in the pan for 10 minutes, then turn out onto a wire rack.
  6. Serve warm.

CNN: How does the climate crisis factor into urban foraging?

Rose: We’ve arrived at a big crossroads. At no other time has our human population had to face and address a rapidly changing climate across the globe. This affects our water systems, our food systems, even determining where we can live — as evidenced by migrations of people moving away from the shores of lakes and oceans.

Urban foraging for wild plants helps us rethink how we live alongside the natural world, looking at habitat loss. We can learn a lot simply by honing our ability to observe the little dandelion or the patch of cattails along the riverside. How might we add back our green spaces that can build soil, support the biodiversity that we need and bring forward our pollinators?

You can’t be what you don’t see. If you don’t have a connection to the water, a farmers market, a vegetable garden or to considering what that dandelion might be doing in the soil, how could you ever become a climate-conscious Earth protector, a steward of the ecosystem?

Foraging helps us pay closer attention, which helps us to reestablish a more caring and less extractive relationship with the natural world.

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Maternity units are closing across America, forcing expectant mothers to hit the road | CNN



CNN
 — 

In picturesque Bonner County, Idaho, Leandra Wright, 40, is pregnant with her seventh child.

Wright is due in August, but three weeks ago, the hospital where she had planned to deliver, Bonner General Health, announced that it would be suspending its labor and delivery services in May.

Now, she’s facing a potentially precarious drive to another hospital 45 minutes from her home.

“It’s frustrating and worrisome,” Wright said.

Wright has a history of fast labors. Her 15-year-old son, Noah, was born on the way to the hospital.

“My fifth child was born on the side of the highway,” Wright said. “It was wintertime, and my hospital at the time in California was about 40 minutes away, and the roads were icy, so we didn’t make it in time.”

By the time she and Noah got to the hospital, about 15 minutes after he was born, his body temperature was lower than normal.

“It worries me not to have a doctor there and worries me to have to go through that,” Wright said.

Residents of Bonner County aren’t the only ones dealing with unexpected maternity unit closures.

Since 2011, 217 hospitals in the United States have closed their labor and delivery departments, according to a report by the health care consulting firm Chartis.

A CNN tally shows that at least 13 such closures have been announced in the past year alone.

Services provided at maternity units vary from hospital to hospital. Most offer obstetrics care in which an obstetrician will deliver a baby, either vaginally or via cesarean section. These units also provide perinatal care, which is medical and supportive care before and after delivery.

Other services provided may include lactation specialists and private delivery rooms.

After May 19, Bonner General Health will no longer offer obstetrical services, meaning there will be zero obstetricians practicing there. Consequently, the hospital will no longer deliver babies. Additionally, the unit will no longer provide 24-hour anesthesia support or post-resuscitation or pre-transportation stabilization care for critically ill newborns.

Some hospitals that have recently closed their maternity units still offer perinatal care, along with routine gynecological care.

Bonner General is planning to establish a clinic where perinatal care will be offered. Gynecological services – such as surgical services, preventative care, wellness exams and family planning – will still be provided at a nearby women’s health clinic.

The Chartis report says that the states with the highest loss of access to obstetrical care are Minnesota, Texas, Iowa, Kansas and Wisconsin, with each losing more than 10 facilities.

Data released last fall by the infant and maternal health nonprofit March of Dimes also shows that more than 2.2 million women of childbearing age across 1,119 US counties are living in “maternity care deserts,” meaning their counties have no hospitals offering obstetric care, no birth centers and no obstetric providers.

Maternity care deserts have been linked to a lack of adequate prenatal care or treatment for pregnancy complications and even an increased risk of maternal death for a year after giving birth.

Money is one reason why maternity units are being shuttered.

According to the American Hospital Association, 42% of births in the US are paid for by Medicaid, which has low reimbursement rates. Employer-sponsored insurance pays about $15,000 for a delivery, and Medicaid pays about $6,500, according to the Health Care Cost Institute, a nonprofit that analyzes health care cost and utilization data.

“Medicaid funds about half of all births nationally and more than half of births in rural areas,” said Dr. Katy Kozhimannil, a public health researcher at the University of Minnesota who has conducted research on the growing number of maternity care deserts.

Kozhimannil says communities that are most likely to be affected by maternity unit closures tend to be remote towns in rural counties in states with “less generous Medicaid programs.”

Hospitals in larger cities are often able to offset low reimbursement rates from Medicaid births with births covered by employer-sponsored insurance, according to Dr. Sina Haeri, a maternal-fetal medicine specialist and CEO of Ouma Health, a company that provides virtual prenatal and perinatal care to mothers living in maternity care deserts.

Many large hospitals also have neonatal intensive care units.

“If you have a NICU, that’s a substantial revenue generator for a hospital,” Haeri said.

Most rural hospitals do not have a NICU, only a nursery where they care for full-term, healthy babies, he said. Due to that financial burden, it does not make financial sense for many rural hospitals to keep labor and delivery units open.

A low volume of births is another reason for the closures.

In announcing the closure, Bonner General noted that in 2022, it delivered just 265 babies, which the hospital characterized as a significant decrease.

Rural hospital administrators providing obstetric care say it takes at least 200 births annually for a unit to remain safe and financially viable, according to a study led by Kozhimannil for the University of Minnesota’s Rural Health Research Center.

Many administrators surveyed said they are working to keep units open despite low birth rates.

“Of all the folks that we surveyed, about a third of them were still operating, even though they had fewer than 200 births a year,” Kozhimannil said. “We asked why, and they said, ‘because our community needs it.’ ”

Another issue for hospital administrators is staffing and recruitment.

The decision to close Bonner General’s labor and delivery unit was also directly affected by a lack of experienced, qualified doctors and nurses in the state, said Erin Binnall, a Bonner General Health spokesperson.

“After May 19th, Bonner General Health will no longer have reliable, consistent pediatric coverage to manage neonatal resuscitations and perinatal care. Bonner General’s number one priority is patient safety. Not having board-certified providers certified in neonatal resuscitation willing to provide call and be present during deliveries makes it unsafe and unethical for BGH to provide these services,” Binnall told CNN by email.

The American Hospital Association acknowledges the staffing challenges some hospitals face.

“Simply put, if a hospital cannot recruit and retain the providers, nurses, and other appropriately trained caregivers to sustainably support a service then it cannot provide that care,” the association said in a statement. “Such challenges are only magnified in rural America, where workforce strain is compounded by aging demographics that in some communities has dramatically decreased demand for services like Labor and Delivery.”

Wright is considering moving because of the lack of maternity and pediatric care available in Bonner County.

More stringent abortion laws may be playing a role in the closures, too.

Bonner General said in a news release last month that due to Idaho’s “legal and political climate, highly respected, talented physicians are leaving. In addition, the Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care.”

According to the Guttmacher Institute, Idaho has one of the strictest anti-abortion laws in the country: a complete ban that has only a few exceptions.

Idaho requires an “affirmative defense,” Guttmacher says, meaning a provider “has to prove in court that an abortion met the criteria for a legal exception.”

No matter the reason, Kozhimannil said, closures in rural communities aren’t just a nuisance. They also put families at risk.

“That long drive isn’t just an inconvenience. It actually is associated with health risks,” she said. “The consequence that we saw is an increase in preterm births. Preterm birth is the largest risk factor for infant mortality. It is a huge risk factor for developmental and cognitive delays for kids.”

Haeri says the decline in maternal care also has a clear effect on maternal mortality rates.

The maternal death rate for 2021 – the year for which the most recent data is available – was 32.9 deaths per 100,000 live births in the US, compared with rates of 20.1 in 2019 and 23.8 in 2020, according to a report from the National Center for Health Statistics. In raw numbers, 1,205 women died of maternal causes in the US in 2021.

Conditions such as high blood pressure, obesity, and diabetes may raise a person’s risk of complications, as can being pregnant with multiples, according to the National Institutes of Health. Pregnant women over the age of 35 are at a higher risk of pre-eclampsia.

As labor and delivery units continue to shut their doors, possible solutions to the growing problem are complex, Haeri says.

“I think anyone that comes to you and says the current system is working is lying to you,” he said. “We all know that the current maternity system is not good.”

Kozhimannil’s research has found that many women who live in maternity care deserts are members of minority communities.

“When we conducted that research, we found the communities that were raising the alarm about this … tended to be Black and indigenous, or tribal communities in rural places,” she said. “Black communities in the South and East and tribal communities throughout the country, but especially in the West, Mountain West and Midwest.”

Haeri says one possible solution is at a woman’s fingertips.

“I always say if a woman’s got a cell phone, she should have access,” he said.

A 2021 study found that women who live in remote areas of the US could benefit from telehealth visits, which would decrease the number of “in-person prenatal care visits and increase access to care.”

The American College of Obstetricians and Gynecologists recommends 12 to 14 prenatal care appointments for women with low-risk pregnancies, and the study suggests that expansion of prenatal telehealth appointments could help women living in remote areas better adhere to those guidelines.

Ouma works with mothers who are typically remote and high-risk, Haeri says.

He also believes that promoting midwifery and doula services would help bolster maternity care in the US.

Certified nurse midwives often assist remote mothers who are high-risk or who decide to give birth at home, he says.

Midwives not only deliver babies, they often work with medical equipment and can administer at-home physical exams, prescribe medications, order lab and diagnostic tests, and assess risk management, according to the American College of Nurse Midwives. Doulas – who guide mothers through the birthing process – are often present at home births and even hospital births.

“That midwifery model shines when it comes to maternal care. [And] doula advocacy involvement leads to better outcomes and maternity care, and I think as a system, we haven’t made it easier for those two components to be really an integral part of our maternity care in the US,” Haeri said.

After living in Idaho for 10 years, Wright says, she and her fiancé have considered leaving the state. The lack of maternity and pediatric care at Bonner General Health is a big reason why.

“I feel safe being with [my] doctors. Now, I have to get to know a doctor within a couple of months before my next baby is born,” Wright said.

As she awaits the arrival of her new son, she feels doubtful that there is a solution for mothers like her.

“Everywhere – no matter what – everybody has babies,” she said. “It’s posing a problem for people who have babies who don’t have the income to drive or have high risk pregnancies or first-time mothers who don’t even know what to expect.”

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