Transcutaneous Electrical Nerve Stimulation (TENS) is a device used for pain relief and is frequently used during labour. It emits low-voltage currents from a portable battery-operated pack and consists of a hand-held control with electrode pads which you attach to your skin to manage the pain of contractions.
Each TENS comes with four sticky pads which you attach where you gain the most relief, usually on your lower back but they can also be applied to acupuncture points or directly to the head. The pads are connected to electrical leads which are attached to a control panel. It is possible to buy replacement pads for TENS machines so the devices can be reused, shared or rented. Control panels also often come with a belt clip and/or neck cord so you can secure the device to your clothing while moving around during labour.
You are in control of the TENS intensity. The hand-held controls allow you to start at a low intensity and increase intensity as your labour progresses. The TENS machine works by sending small electronic pulses through the machine to the leads and the pads which are attached to your skin. When using a TENS you will feel a ‘buzzing’ or ‘tingling’ feeling which can be increased from low to high intensity. An obstetric TENS machine, designed specifically for use during labour, will usually have a “boost” button on the control pad which you can press to temporarily increase the intensity of the pulses.
TENS is believed to change or suppress the way our brain receives signals of pain. The electrical pulses are thought to stimulate nerve pathways in the spinal cord which block the transmission of pain. You may find the TENS is a good distraction during labour. Many women find TENS helps them feel in control. TENS machines are thought to be most helpful in the early stages of labour, however, there is little evidence to suggest that TENS is an effective form of pain relief. Anecdotally, women report it being a good support or distraction to them if used from very early on in their labour.
TENS is not recommended if you have a pacemaker or epilepsy. It is not recommended to use over the uterus.
Advantages of TENS
- you are in control of when to use the TENS and intensity
- TENS acts as a distraction
- many women find TENS is effective in early labour
- you can move about freely while using the TENS
- you may use the TENS at home or if you decide to leave the maternity unit
- A TENS with a boost button offers you full control over the intensity of the device
- There is some evidence that women using TENS are less likely to rate their pain as severe but results were not consistent.
- Many women who have used a TENS during labour say they would be willing to use TENS again in a future labour.
Disadvantages of TENS
- you will need your partner to help you place the pads on your back
- you cannot use TENS in water – bath, shower, or birth pool
- you may need to remove the TENS if you have a CTG
- you may not find it is effective pain relief
- you may find the sensation irritating
It is worth noting that a Cochrane Review of the use of TENS during labour found that its use did not seem have an effect on the length of labour, interventions in labour, or the well-being of mothers and babies.
What women say:
“I used TENS on my first from the early stages (when pains were about 10-15 minutes apart) until I got to the hospital. I was 7cm on admission. I found TENS great and think it helped me stay home as long as I did”
“I used TENS at home and found it grand for backache but not the pains in the front. When I got to hospital I had to take it off for the CTG anyhow”
“I really didn’t like it – I found it frustrating trying to press buttons as I was having contractions and the sensations really annoyed me. I found it much easier to cope once I took it off and I could just focus on each contraction!
“It was fantastic for pre-labour warm up that went on for days and for the car journey into hospital.”
References & Additional Reading:
No Epidural? Pain management alternatives and tips – Part 1