It has been a busy, busy year for La Rosa Midwifery birth team. I wanted to share some of the projects that I have worked on. One that was the culmination of just about 2 years was the NARM Prep Jumpstart Program, through Californian's for the Advancement of Midwifery. This was a study retreat for people of color only. Us midwives and midwifery supporters worked hard together on the Birth Disparities and Equity Team to bring this program to life and create a learning and nurturing environment for student midwives of color. 
I also have been holding multiple gatherings for my clients; such as a fall gathering and Community Walk & Talks. 
My practice has had students now for the past 2 years. This has been a wonderful experience of growth and enrichment. Having students is something that is very important to me and to the advancement of midwifery in my opinion. Together we learn and grow, they have been a great reflection for me. Currently my student is Ana Ruiz, who is a dedicated and intuitive birth worker she is from Chino Hills and has been a lovely addition to the La Rosa team. 
In this past year I have hosted multiple Skill's Days for my students and other local student midwives. We have gone over things like setting up and administering IV's, suturing skills, basic vitals and newborn exams; all of theses things help to enrich and grow the skills of these students to have and use in practice. We even held an amazing well-person clinic day that was open to the community, where we offered well person exams, paps, STI testing and breast/chest exams at lab cost only, no fee for the exam itself. 
I have been an active member on the CALM (California Association of Licensed Midwives) board of directors. 
The students Julie and Ana hosted Childbirth education courses, which will be offered again in the new year. 
We participated in a photoshoot for CALM and for the advancement of midwifery. 
We have all taken multiple Spinning Babies classes and learned so much about body balancing and shifting the paradigm of the cervix centric model for labor and delivery currently. This has helped change the way that we view birth and the approach of our care and practice. 
With all of this life has been busy yet fulfilling. We have welcomed many babies earthside and witnessed many mamas be born. 

For this upcoming year we have plans of a Newborn Care 101 class, more Childbirth Education courses, workshop for providing culturally inclusive care for LGBTQ families, another Well-Person Day and much more, so stay tuned and connect on the Instagram and Facebook pages. 
Intentions for La Rosa Midwifery this next year of 2020 are

• to walk forward in an intentional way and to meet our clients where they are, providing the most individualized care we can.
• To build bridges with other care providers & birth workers in our community. 
• Grow more midwives of color
• Serve more families in need of midwifery/holistic care 
• Create more safe spaces and workshops 

Warm wishes to all and heres to 2020 being the start of an amazing decade! 

I have been trucking along on my fermentation journey, attempting to get probiotics in a whole food DIY way. I wanted to follow up because I know you all have just been waiting for my follow up haven't you! 

So I wish I could say that my sourdough bread is on point now but, unfortunately not so. That being said I do think that I have figured out a formula for my next batch. I recently heard that it takes making sourdough 10 times to get into the rhythm. I am pretty determined but did get a little defeated last bake so I took a little break and am ready to get back at it, this week actually. 

Sauerkraut
I have had much better success with my sauerkraut. I am working on my 3rd batch and I am happy to report that my honey has been asking for more. So basically I am having to have it on rotation at all times. This time I am making it with purple cabbage which turns out to be a super cool fluorescent pink. I just love how very easy and yummy sauerkraut is! 
I followed the simple recipe from my little book "Wild Fermentation" by Sandor Ellix Katz which you can find here: www.wildfermentation.com

Ingredients for one gallon: 
Cabbage (approximately 5 pounds) 
Sea salt (approximately 3 tablespoons) 

Special Equipment: 
Ceramic crock or food-grade plastic bucket. Cylindrical shape is what your looking for. 
Plate that fits inside crock or bucket. 
One gallon jug filled with water. 
Cloth cover
Process: 
Chop or grate cabbage, finely is what i've found works best, with or without hearts, however you like it. I love the purple cabbage as it turns into bright pink kraut. 

Sprinkle salt on the cabbage as you chop it. The salt makes the cabbage sweat, and this creates the brine (salty water) in which the cabbage can ferment and sour without rotting. Do not use iodized salt because iodine inhibits bacterial action. 
Three tablespoons of salt is a rough average. According to the food scientists, the sauerkraut process works best in 2-3 percent brine solution. I never measure the salt, I just shake some on after I chop up each quarter cabbage. I use more salt, in the summer, less in the winter. It is possible to make krautwithoutsalt, using ground kelp and other sea vegetables instead. 

Add other vegetables (onions, garlic, other greens, brussel sprouts, small whole heads of cabbage, whatever) and herbs and spices (caraway seeds, dill seeds, anything) as you like. Experiment.
Mix ingredients together and pack into crock/bucket. 
Pack just a bit into the crock at a time and tamp it down hard using your fists or a bean masher. The tamping packs the kraut tight in the bucket and helps force water to of the cabbage. 

Cover kraut with a plate or some other lid that fits snugly inside the bucket. Place a clean weight, like a gallon jug filled with water on the cover. This weight is what will keep the cabbage submerged in the brine. Cover the whole thing with a cloth or pillow case to keep dust and flies out. 

Press down on the weight periodically until the brine rises above the cover. This can take a while, as the salt slowly draws water out of the cabbage. Some cabbage, particularly if it is old, simply contains less water. If for some reason the brine doesn't rise above the plate level by the next day, add enough salt water to bring the brine level above the plate. 
Check the kraut after a few days. If any moldy scum appears on the surface, scraps it away. Taste the kraut. It should start to be tangy after a few days, and the taste gets stronger as time passes. The process is faster in summer, slower in winter. 

Enjoy, 
Scoop out a bowlful at a time and keep it in the fridge. Each time you scoop out some kraut out of the bucket, you have to repack it carefully. Make sure the kraut is packed tight in the bucket, the surface is level, and the cover and weight are clean. Sometimes brine evaporates, so if the kraut is not submerged below brine just add salted water as necessary. 
 
Develop a rhythm 
Start a new batch before the previous batch runs out, especially if you have a partner who is loving it and eating it by the bowlful. I take what remains in the bucket out, pack the bucket with fresh salted cabbage, then pour the old kraut and its juices over the new kraut. This gives the new batch a boost with an active culture starter. 

My most recent batch of hot pink sauerkraut, not quite ready, I want it a little more tender. Because its been hot I have had to add some salted brine water once. Can't wait to eat it :) 

I have also had great success with keeping my S.C.O.B.Y alive and having a rotation of kombucha going, for my last batch I added black cherry tea which added a really yummy flavor to the tea. 

I hope you have enjoyed my sauerkraut and fermentation frenzy update and I hope you have success getting probiotics from  home made sources. 
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I have recently been getting lots of questions on how to increase fertility and have had many close people in my life trying to conceive. This has prompted me to read up on ways to increase fertility and to call on my midwifery training. What I have been focusing on is just some generally good supplements to increase fertility and to get the body ready to welcome a baby,  a sort of pre-conception body prep. 

Eating a wide variety of plant-based foods is a great way to get macro and micro nutrients, even with a great diet it may be difficult to get the amount of vitamins necessary to increase fertility. Many care providers suggest taking a prenatal vitamin for 3-6 months before conceiving to boost vitamin levels up, not all prenatal vitamins are equal and something that is plant-whole-food based is much more optimum. The problem with a combined prenatal is that it is not individualized to your needs and most do not have all that you need for specific vitamins such as Vitamin D3 or have folic acid as opposed to folate or methylfolate. 

Disclosure: This is by no means an exhaustive resource on this subject and if you have been trying to conceive for a year or more, it is best to consult with a qualified care provider to help guide you through your fertility options. 

So here is a list of some herbs and supplements which can boost fertility: 

• Chasteberry (Vitex)- 500-1000mg daily, regulates menstrual cycle & prolactin levels, enhances corpus luteum development, and corrects relative progesterone deficiency
• Maca powder- 3-6 grams (1-3 tsps) daily, Maca is considered an adaptogen and works specifically with the endocrine system, to balance hormones in both men and women. Both partners should take this supplement. (Women should consider using Red Maca which is best for female fertility. Men should use Black Maca for their fertility which has been shown to increase sperm count and sperm motility)
• You can make a nice herbal infusion/tea comprised of Red Raspberry Leaf, Nettle, and Dandelion to drink daily, this can also be taken while pregnant as a nice pregnancy tea. 
• Red Raspberry Leaf- A well known fertility herb, that is lovely in your pregnancy tea as well. This herb is best taken as an infusion (herbal tea). Drink 1 cup, 1-3 times a day. Pour ¼ cup of dried red raspberry leaf into a quart mason jar, fill with freshly boiled water, cover and let steep for at least 15-30 minutes, can also be taken in pill form as well. 
• Nettle Leaf– Has a very high mineral content. It contains lots of chlorophyll and is nourishing to the adrenals and kidneys. It helps reduce stress and is a powerful uterine tonic and kidney and liver function booster. 
• Dandelion– Contains vitamins A and C as well as trace minerals. The root is beneficial to the liver and the leaf is mildly diuretic. Can help cleanse the body and remove toxins which is something to strive for when trying to conceive.
  
• Vitamin D3- A recent study found women taking 4,000 IU of vitamin D daily had the greatest benefits in preventing preterm labor/births and infections. Most people are deficient in vitamin D and this vitamin is important for so many things such as fertility, immune health, cardiovascular health and mood. One of the easiest ways of obtaining Vitamin D3 is by eating eggs, fatty fish, and dairy, as well as taking cod liver oil, you can also take it in supplement form.  It is best to get tested to assess how much you will need daily. 
• Folate (not folic acid)- Women hoping to get pregnant should take at least 2,000 micrograms a day. Folate is well known as a necessary vitamin in early pregnancy to prevent complications, but it is most beneficial when taken for several month before the pregnancy as well as during. It helps cell division and promotes ovulation.  It is important to note that many people have trouble using the synthetic form, folic acid, and do better with folate or methylfolate. 
  
• Omega's (3,6 &9)- Minimum 1,000 milligrams per day, preferably 2,000 mgs, up to 5,000 milligrams. Omega's regulate reproductive hormones, increase the blood flow to the uterus, which can help with uterine lining development, reduce inflammation, which for fertility can be especially important in the pelvic area, and reduce sensitivity to the hormone prolactin, which can suppress ovulation. 

Nutrition is paramount to health and fertility as it is really the foundation of what is to come. Here is a list of nutritional things to consider and follow. 

• Proper nutrition is so key to body health in general but also important for conception; eliminating as many processed foods as possible such as processed starches, sugars and starches. Some other good source of starches would be sweet potatoes, squash, and root vegetables. 
• Increasing healthy fats such as avocados, olive oil, olives, coconut oil, grass-fed meats, eggs and butter. 
• Boosting protein intake is so important for conception as well as pregnancy. Some good sources are nuts, legumes, eggs and grass-fed meats. 
• Eat lots of vegetables daily, like I mentioned before this is where you will get the micro nutrients that are so important to your health, some examples are dark leafy greens, bell peppers, spinach, kale, chard, lettuce and cabbage. 
• Hydration is so important for cell maintenance and almost all functions in the body. Also important and crucial during pregnancy. 

Please share below any other supplements that you have found to work for you in your fertility journey I would love to hear your stories and ideas! 

So let's talk sourdough bread and how to begin the process. I love me a yummy crusty sourdough slice slathered with rich butter and so I decided a few months back to create my own starter and start baking it myself! So far it has been full of trial and error, but so goes the DIY struggle I suppose (and part of the fun). I would say that each loaf has been better then the last but I still am searching for the perfect loaf/perfect starter. 

I love all things fermented and this is partly because I know how important gut health is to ones overall health. Probiotics are especially important during pregnancy as quality probiotics:

• Help ensure that baby will get a good dose of beneficial bacteria during a normal vaginal delivery, which can reduce risk of ear infection and illness in the first few years. 
• Probiotics also help mom avoid illness and constipation during pregnancy and boost the immune system
• They can also reduce the risk of Group B strep overgrowth. 

Once I started to search the inter-webs on how to make my own starter I came across a lot of info on the benefits of sourdough. Here are a few: 

• Sourdough bread contains the bacteria Lactobacillus in a higher proportion to yeast than do other breads. More Lactobacillus means higher production of lactic acid, which means less of the potentially dangerous phytic acid. And what does that mean? More mineral availability (particularly k, p, Mg, Zn) and easier digestion!
• Easier digestion is made even more possible by the bacteria-yeast combo working to predigest the starches in the grains. Predigestion by sourdough = less digestion for you.
• Lactic acid bacteria (LAB – including those commonly found in sourdough bread) produce beneficial compounds: antioxidants, the cancer-preventive peptide lunasin, and anti-allergenic substances, some of which may help in the treatment of auto-immune diseases.

I have been in  a fermentation frenzy this past month and wanted to share a little about it. I started my own kombucha S.C.O.B.Y from one store bought bottle, made sauerkraut, and have continued my sourdough bread journey :) All of these fermented foods increase the probiotics in your system and are so very essential in any pregnant mamas daily regimen especially when they are home made and fresh. 

Lets start with the sourdough starter: I loved the idea that I could create my own sourdough starter from just 2 simple ingredients: flour and water. The rest is the magic of natural bacteria in the air, how cool is that! 

There was so many options and ways to go about beginning the sourdough starter I finally chose to follow this recipe: www.culturesforhealth.com/learn/sourdough/how-to-obtain-sourdough-starter/

Here's what you need: Mason jar or any glass jar, pyrex spatula, measuring cups, rye flour & all purpose flour (or any flour you choose, I chose rye because it is a hardier flour and is less easy to mess up), and filtered room temperature water. 

                                                                SOURDOUGH STARTER RECIPE

1. Combine ¾ cup flour and ½ cup warm water in a glass or plastic container. Make sure the container can hold about 2 quarts, to avoid overflow.
2. Stir vigorously to incorporate air; cover with a breathable lid.
3. Leave in a warm place, 70-85°F, for 12-24 hours. Feeding every 12 hours will increase the rate at which your sourdough starter is multiplying its organisms; feeding every 24 hours will take a bit longer, but may be more sustainable depending on your time commitment.
4. At the 12 or 24 hour mark you may begin to see some bubbles, indicating that organisms are present. Repeat the feeding with ½ cup warm water and ¾ cup flour.
5. Stir vigorously, cover, and wait another 12-24 hours.
6. Repeat feedings every 12-24 hours by removing half of the starter before every feeding and discarding it. Feed with ½ cup warm water and ¾ cup flour.
7. After about 5-7 days the sourdough starter should have enough yeasts and bacteria to be used for baking.

I have been using the measuring cup method but all that I have read is that it is best to weigh out your ingredients, so I think I am about to purchase one as my bread is still coming out a little bit dense and I think it is from my starter not being as active as it could be. As for bread recipe itself I have used a few but here is one that I really liked: blog.kingarthurflour.com/2017/02/09/multigrain-sourdough-sandwich-bread/#.WKiv5ztSPr4.gmail

Overall, consuming probiotics is a benefit to your health and the health of your baby, however you can get them. I personally think getting them from home made sources is the best way so I will continue to write about the different methods of fermenting here on my blog, for your viewing pleasures... 

Water is life! Cells are fundamental to life. 

Water is important to cells because without it they would not be able to remove waste, bring in nutrients or transport oxygen. The body is a very intricate system where many parts rely on each other.
While it is always a good idea to keep the body hydrated, there are certain times when changes in the body call for more water. One of these times is during pregnancy. Water can be the answer to alleviating many of the discomforts of pregnancy and aids in preparing the body for these physiological changes.

​The fluid acts as the body’s transportation system, and carries nutrients through the blood to the baby. Also, flushing out the system and diluting urine with water prevents urinary tract infections, which are common in pregnancy.

Perhaps the biggest reason to drink water however is to keep the body hydrated. Dehydration in pregnant women can be very serious. Hormones change the way women store water during pregnancy, so they begin to retain water and drinking plenty of water combats that.
Much of that water is used in the amniotic sack. Amniotic fluid alone needs to replenish itself every hour by using roughly a cup of water stored in the body. Replacing that water will insure the unborn baby is protected within the womb. Since the blood volume increases to nearly double by the eighth month of pregnancy, it is necessary to drink even more water to compensate. Thicker blood can lead to hypertension and other cardiovascular problems.

Because dehydration can cause contractions, lack of water in the third trimester is one of the primary causes of premature labor. Premature labor can have many risks to the newborn baby. However, some cases of premature labor have been stopped just by giving the mother enough water to re-hydrate her body. Pregnant women should be sure to drink at least eight 8-ounce glasses of water each day, which is in addition to the normal intake of other recommended foods. The benefits of drinking water during pregnancy include healthier skin, less acne, washing away of unnecessary sodium, less chance for preterm labor or miscarriage and better bowel movements. Drinking water can, believe it or not, also help prevent that nausea known as morning sickness, as care providers recommend drinking plenty of fluid between meals. 

                                           Ways to get enough water throughout the day

• Pregnant women should be nibbling protein about every three hours. If you drink a glass of water each time you nibble, this can help you stay hydrated.
• At the beginning of the day fill a gallon jug or 3-4 containers with your daily allowance of fresh water. Throughout the day self assess and see if you need more, and be conscious about getting it! 
• Bring a water bottle with you wherever you go.
  
  

Here's a recipe for a delicious and nutritious pregnancy tea, that is tried and true. A very good tonic during pregnancy, to mix it up as plain water can become "boring" to some, especially if you should be drinking close to a gallon a day. 
                                                                  Pregnancy Herbal Infusion

• 1⁄4 oz Red Raspberry leaves
  
• 1⁄4 oz Red Clover blossoms and leaves
  
• 1⁄4 oz Nettle leaves
  
• 1⁄4 oz Dandelion leaves
  Directions:
  1. Place each herb into a nonmetal container (ideally a glass jar with lid)
  2. Heat up one quart (32 oz or 4 glasses) of water
  3. Once the water is boiling, pour it into the container with herbs already in it and cover 4. Steep at least four hours (or overnight)
  5. Strain out herbs
  
  Sip often throughout day. Drink warm (reheat on stovetop), at room temperature, or cold. If you’d like to add a little flavor you can add a tea bag of peppermint tea, honey, or 1-2 slices of lemon or lime. 
  
  Warm regards! And remember to drink your water :)