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A, Suites 10 & 20, Red Bluff (530) 527-3100 http://redbluff.stromerrealty.com Gold Exchange 423 Walnut St., Red Bluff 530 528-8000 T-F 10am-5:30 pm • Sat 10am-4pm Established 1994 Pawnbroker with a Heart • Checks Cashed • Income Tax • Local Payroll • Jewelry • Coins 25% off Jewelry Guidelines to reduce C-section births urge waiting WASHINGTON (AP) — Show more patience in the delivery room: That's the prescription being given to the nation's obstetricians. New guidelines say doctors should give oth- erwise healthy women more time to deliver their babies vaginally before assuming that labor has stalled. The recommendations are the latest in years of efforts to prevent unnec- essary C-sections. ''Labor takes a little longer than we may have thought,'' said Dr. Aaron Caughey, who co-authored the guide- lines for the American College of Obstetricians and Gynecologists. The recommenda- tions are being pub- lished jointly Thursday by two groups of preg- nancy specialists — ACOG and the Society for Maternal-Fetal Med- icine — amid growing concern that C-sections are overused. Nearly 1 in 3 women in the U.S. gives birth by cesarean. Yes, C-sec- tions can be life-saving for mother or baby. But they also can be done for convenience or fear of lawsuits, and the surgery can bring some serious health risks. And having one cesare- an greatly increases the chances that a next pregnancy will end in one, too. One of the main rea- sons for a first-time C- section is labor that's progressing too slowly, ACOG's analysis found. How long should labor take? There's no clear-cut deadline, and every woman is differ- ent, stressed Caughey, obstetrics chairman at the Oregon Health and Sciences University. ''My patients ask this every day,'' he said. He tells them it can ''run the gamut from six hours long, start to fin- ish, to three and four days'' at the other extreme. Whether labor is too slow is assessed at dif- ferent time points — and what doctors were taught in medical school about the different stages may not be the most up-to-date. A 2012 study from the National Institutes of Health found that one particular stage takes up to 2 1/2 hours longer now than it did in the 1960s, when many labor definitions were set. Partly that's because today's mothers-to-be tend to be older and weigh more. But it's also because of some changes in obstetric practice, such as more use of painkilling epidu- rals that can slow labor. So the obstetricians' group took a closer look. Among the recom- mendations for other- wise low-risk mothers and babies: —Don't order a C- section just because the first and longest phase of labor is prolonged. This so-called latent phase is when contrac- tions are mild and far apart, and the mother's cervix is barely dilated. Historically doctors considered it stalled if it lasted longer than 20 hours for a first-time mom, or 14 hours for other mothers. —''Active labor'' begins later than once thought, not until the cervix is dilated 6 cen- timeters. Active labor is when contractions become stronger and more frequent, and the cervix begins to dilate more rapidly until the woman eventually is ready to push. Doctors once thought active labor began when the cervix was dilated 4 centimeters, but recent research shows that dilation remains pretty slow until reaching the new threshold. That's an important change because many doctors won't admit women to the hospital until they're in active labor, unless they need more care for another reason. ''As soon as someone is admitted to the hospi- tal, they're kind of on the clock,'' Caughey said. —If women aren't too tired, allow them to push at least two hours if they have delivered before, three hours if it's their first baby. They may push longer if they had an epidural as long as the doctor can see progress. —Forceps can offer a safe alternative to cer- tain cesareans if used by an experienced, well- trained physician. Few physicians today under- go the training. The advice shouldn't be a surprise to doctors who've been paying attention to recent research about labor times, but it's hard to predict how quickly they'll change long-term practices, Caughey said. Some women's groups have long warned that rushed labor was fueling cesareans, and Lamaze International welcomed the guidelines and said mothers-to-be need to know them, too. ''They need to have a better understanding of what normal labor is,'' said Lamaze president Michele Ondeck. She advised expec- tant mothers to ask about the cesarean rate before choosing an obstetric practice, and then before the due date to discuss how the doc- tor supports women in labor and what he or she considers too long. If the doctor says labor has stalled, it's OK to ask if mom or baby is in danger and if there are alternatives to an imme- diate cesarean, Ondeck said. Jazz study shows link between music and language WASHINGTON (AP) — Jazz musicians are famous for their musical conversations — one improvises a few bars and another plays an answer. Now research shows some of the brain's language regions enable that musical back-and- forth much like a spoken con- versation. It gives new meaning to the idea of music as a universal language. The finding, published Wednesday in the journal PLoS One, is the latest in the growing field of musical neu- roscience: Researchers are using how we play and hear music to illuminate different ways that the brain works. And to Dr. Charles Limb, a saxophonist-turned-hearing specialist at Johns Hopkins University, the spontaneity that is a hallmark of jazz offered a rare chance to com- pare music and language. ''They appear to be talking to one another through their instruments,'' Limb explained. ''What happens when you have a musical conversation?'' Watching brains on jazz requires getting musicians to lie flat inside a cramped MRI scanner that measures changes in oxygen use by different parts of the brain as they play. An MRI machine contains a giant magnet — meaning no trumpet or sax. So Limb had a special metal-free keyboard manufactured, and then recruited 11 experienced jazz pianists to play it inside the scanner. They watched their fingers through strategically placed mirrors during 10- minute music stretches. Sometimes they played scales. Other times, they did what's called ''trading fours,'' where the pianist made up four bars, and then Limb or another musician-scientist in the lab improvised four bars in return, and the pianist responded with still new notes. That conversation-like improvisation activated brain areas that normally process the syntax of language, the way that words are put togeth- er into phrases and sentences. Even between their turns play- ing, the brain wasn't resting. The musicians were process- ing what they were hearing to come up with new sounds that were a good fit. At the same time, certain other regions of the brain involved with language — those that process the meaning of words — were tuned down, Limb found. That makes sense because ''the richness of the structure of music is what gives it its significance,'' Limb said. ''You can have substantive discourse using music, with- out any words, yet language areas of the brain are involved in this unique way.'' One ultimate goal of musi- cal neuroscience is to better understand the brain's circuit- ry, and how it can rewire itself, in hopes of eventually finding new treatments for neural disorders. Limb made headlines several years ago when he measured jazz musi- cians' riffs — longer, solo improvisations — to study creativity in the brain. ''We know nothing about how the brain innovates,'' he said. ''This is one way to learn what innovation means neuro- logically.'' Stay tuned: Next he hopes to study children who are just learning music, and to com- pare amateurs to profession- als, as he explores how people become creative. Community Clip? e-mail: clerk@red- bluffdailynews.com or Fax: 527-9251