Pain relief for your labour without drugs - What is TENS?

The use of TENS in labour is common in Britain, but here in Australia it seems to be the best kept secret in natural birthing. So here's the 411 on using TENS for your birth from Babycentre in the UK.

What is TENS?

TENS is a drug-free kind of pain relief often used by women in early labour. TENS stands for Transcutaneous Electrical Nerve Stimulation.

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.

The machine sends small, safe pulses of electrical current via the leads to the 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.

A TENS machine has buttons that you can use to control the frequency and strength of the pulses. There's also a boost button for you to press with your thumb when you want maximum output from the machine. This may help you to get through each contraction. 

Cranial TENS is an alternative to maternity TENS that may help with pain relief once you're in active labour. Instead of pads, you wear a band around your head. The band delivers electrical impulses to your forehead, just above your nose.

How does a TENS machine work?

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

  • the electrical pulses prevent 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’s not a lot of evidence to show how effective using a TENS machine is as a form of pain relief but most midwives are supportive of the idea of using one. About one woman in five plans to use TENS at some point in labour and most mums who've tried it say that they’d be willing to use it again in their next labour.

When should I use TENS?

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 that the machine works better at relieving your backache than other types of pain. This is probably because the pads are on your back.

TENS is most likely to be effective in early labour though you may still need other forms of pain relief as your labour gets stronger.

Your midwife will not recommend starting TENS if you’re already in established labour. 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 the pads could affect the signals to the monitoring machine.

How should I use TENS?

Your birth partner can place the pads on your back for you. Follow the instructions that come with your maternity TENS machine, though they're likely to be as follows:

  • 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 will make TENS more effective.
  • Don't give up straight away if you think TENS isn't doing anything. You may need to keep using it for at least an hour before it starts to work for you.
  • 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 is working for you. All other forms of pain relief, both medical and non-medical, are still open to you.

When shouldn't I use TENS?

Never use a TENS machine under the following circumstances, without talking to a midwife or doctor first:

  • Before you go into labour.
  • When you’re in a shower, bath, or birth pool.
  • If you have broken skin or a healing scar where you want to place the pads.
  • If you have a cardiac pacemaker or a heart rhythm problem.
  • If you have 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 if 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.

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, he’ll have to work around the pads.

 

Hire a TENS now for 8 weeks with postage included, or pre-book for your labour here.

Originally published: https://www.babycentre.co.uk/a542581/using-a-tens-machine-in-labour