Using A TENS Machine In Labour - BabyCentre UK

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1. Pregnancy /
2. Labour and birth

Using a TENS machine in labourMedically reviewed by Clare Herbert, Senior midwife and team leader Written by Lorna MarshPhoto credit: iStock.com / lostinbidsIN THIS ARTICLE

• What does a TENS machine do?
• How does a TENS machine work for pain relief?
• When should I use TENS for labour pain?
• How should I use TENS?
• When shouldn't I use TENS?
• What are the advantages of TENS?
• What are the disadvantages of TENS?
• How do I get a TENS machine?
• Other types of pain relief for labour

TENS is a method of pain relief that uses a mild electrical current, often used in the early stages of labour. TENS stands for Transcutaneous Electrical Nerve Stimulation. If you are thinking about using TENS for pain relief in labour, you will need a TENS machine specifically designed for maternity use. A maternity TENS machine consists of a battery-powered, hand-held controller connected by fine leads to four flat pads. The pads are covered in a firm gel that helps them stick to your back.

What does a TENS machine do?

The machine sends small, safe pulses of electrical current via pads on your skin. The pulses pass through your skin and into your muscles and tissues. This gives you a gentle tingling or buzzing sensation, which may be stronger or weaker, depending on the setting level. The controller part of the TENS machine is easy to hold in your hand while you're in labour. But if you don't want to hold it, you can clip it to your clothing or attach a strap and hang it around your neck. Advertisement | page continues below A TENS machine has buttons that you can use to control the frequency and strength of the pulses. There's also a boost button you can press with your thumb when you want maximum output from the machine. This may help you to get through each contraction. Around one in eight people use a TENS machine during labour.

How does a TENS machine work for pain relief?

We don’t know exactly how TENS helps you cope in labour. It’s probably due to a combination of factors. These could include:

• the electrical pulses block pain signals from reaching your brain.
• the pulses stimulate your body to release natural, feel-good substances called endorphins.
• it helps you to feel in control of your labour and be less anxious.
• it offers a distraction from your contractions.

There isn’t much evidence to show how effective using a TENS machine is as a form of pain relief but it’s popular with women in labour, and most midwives are supportive.

When should I use TENS for labour pain?

You can use TENS from the very beginning of your labour. You could start using it when you're getting regular contractions or backache. You may find the machine works better at relieving your backache than other types of pain. This is probably because the pads are on your back. Many people find TENS to be most helpful in early labour, but you may find it also helps throughout the first and second stages. However, you may need additional forms of pain relief as your labour gets stronger. Your midwife will not recommend starting TENS if you’re already in established labour, as it’s not thought to be beneficial if you only start it then. However, if you started using TENS earlier and want to carry on using it, that's fine. You may need to take off the TENS pads if your baby's heart has to be monitored electronically, because it could have an effect on the electrical equipment.

How should I use TENS?

Michelle State-Tomlinson for BabyCenter Your birth partner can place the pads on your back for you. Follow the instructions that come with your specific maternity TENS machine, though they're likely to be similar to the following: Advertisement | page continues below

• Check the machine is turned off before placing the pads on your back.
• Place two of the pads on either side of your spine, with the tops of the pads at about bra-strap level.
• Place the other two lower down, at about the level of the dimples on your lower back, just above your bottom.
• Switch the machine on, starting with the controls at the lowest setting. Turn them up gradually as your contractions get stronger, or when the pain in your back gets worse.
• Use the boost button at the peak of each contraction. The boost function results in more intense, wave-like tingling or buzzing sensations.
• Remember to turn off the boost button again when the contraction has ended. This is so you feel the benefit of the boost next time you have a contraction.
• Keep mobile. Moving around during labour helps you to feel in control and can also help you cope with the pain of contractions.
• If the pads start to lose their stickiness, rub a few drops of water into the gel side of the pads before putting them back on. The more firmly the pads are stuck on, the better they'll work.
• If you don't think the pads are helping you after a while, take them off. You are in control of your labour and what’s working for you. The usual pain relief options will still be available to you if you find TENS doesn’t work.

When shouldn't I use TENS?

You should never use a TENS machine when you’re in a shower, bath, or birth pool. Seek advice from a midwife or doctor first before using a TENS machine if you have:

• Epilepsy.
• Broken skin or a healing scar where you want to place the pads.
• A cardiac pacemaker or a heart rhythm problem.
• Pain that you don’t think is labour pain. See your doctor or midwife if this is the case.

What are the advantages of TENS?

• You can keep moving around while using it.
• It won't directly interfere with your labour.
• You can use it for as long as you want to and take it off whenever you want or need to.
• There are no lasting side-effects.
• It's safe for you and your baby.
• You don't need an anaesthetist, doctor or midwife to help you use it.
• It can be used for a home birth.
• It's portable and non-invasive.
• You control it.
• It's easy to use.

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What are the disadvantages of TENS?

• You probably won’t be able to put the pads in place without help.
• You may find it only gives you relief in the early stages of labour.
• You‘ll probably need to pay to hire or buy a TENS machine, as not all hospitals have them.
• TENS can’t be used in water, though you can still use it before you get in a bath or birth pool.
• If you want your birth partner to massage your back, they’ll have to work around the pads.

How do I get a TENS machine?

You'll probably need to hire, buy or borrow a TENS machine for use at home, while you're in early labour. Not many hospital maternity units provide TENS machines. If you're having your baby in a hospital, you probably won't be admitted until you're in active labour. By then, TENS won’t work as well for you. That's why hospitals invest in other methods of pain relief. Birth centres or midwife-led units may be more likely to have TENS machines, but most rely on you bringing your own. When you go through your birth plan with your midwife, talk to them about renting a machine. There are many types of maternity TENS machines available to hire. It costs from around £25 to £30 to hire one for a month to six weeks. Shop around online for the best deal. If you have sensitive skin, it's worth finding out if your chosen machine comes with hypoallergenic pads. Advertisement | page continues below It may be cheaper in the long run to buy rather than hire. You could share the cost with a pregnant friend or relative, or use it again yourself in the future to get the best value. TENS can also be used for other types of pain, such as arthritis, back pain and period pain.

Other types of pain relief for labour

Explore some of your other pain relief options:

• Entonox (gas and air)
• Epidural
• Diamorphine
• Complementary therapies

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• Entonox (gas and air)

  By Lorna Marsh

• How can I get through early labour at home?

  By Chess Thomas

• Natural pain relief in labour

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• Mobile epidural

  By Jenny Leach

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Sources

BabyCentre's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organisations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

CQC. 2019. 2018 survey of women’s experiences of maternity care. Care Quality Commission. London: CQC. www.cqc.org.ukOpens a new window [Accessed January 2021] Dowswell T, Bedwell C, Lavender T, et al. 2009. Transcutaneous electrical nerve stimulation (TENS) for pain management in labour. Cochrane Database of Systematic Reviews. www.cochranelibrary.comOpens a new window [Accessed January 2021] Jones L, Othman M, Dowswell T, et al. 2012. Pain management for women in labour: an overview of systematic reviews. Cochrane Database of Systematic Reviews. 3: CD009234. www.cochranelibrary.comOpens a new window [Accessed January 2021] Lawrence A, Lewis L, Hofmeyr GJ, et al. 2013. Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews NCT. 2019. Labour pain relief: TENS machine. NCT. www.nct.org.ukOpens a new window [Accessed January 2021] NHS. 2018. TENS (transcutaneous electrical nerve stimulation). NHS, Health A-Z. www.nhs.ukOpens a new window [Accessed January 2021] NHS. 2020. Pain relief in labour. NHS. www.nhs.ukOpens a new window [Accessed January 2021] NCCWCH. 2017. Intrapartum care: care of healthy women and their babies during childbirth. National Collaborating Centre for Women's and Children's Health, Clinical guideline, 190. www.nice.org.ukOpens a new window [Accessed January 2021] OAA. 2016. Pain relief for labour. How do the options compare? Obstetric Anaesthetists Association. LabourPains.comOpens a new window [Accessed January 2021] OAA. nd. FAQs pain relief.Obstetric Anaesthetists Association. LabourPains.comOpens a new window. [Accessed January 2021] Shahoei R, Shahghebi S, Rezaei M, et al. 2017. The effect of transcutaneous electrical nerve stimulation on the severity of labor pain among nulliparous women: A clinical trial. Complement Ther Clin Pract 28:176-80 Lorna MarshLorna Marsh is freelance editor at BabyCentre. She has more than 20 years’ journalism and editing experience, including working for the NHS. Opens a new window Opens a new window Opens a new window

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