Medical News Today published a press release citing a 2009 review by the Cochrane Collaboration that concluded that women should have the option of using transcutaneous electrical nerve stimulation (TENS) as a non-pharmacological method of pain management in labor.
The full report can be found on the Cochrane Collaboration’s website. The summary reads:
“TENS is a device which emits low voltage currents which has been used for pain relief in labour. The way that TENS acts to relieve pain is not well understood. The electrical pulses are thought to stimulate nerve pathways in the spinal cord which block the transmission of pain. In labour, the electrodes from the TENS machine are usually attached to the lower back (and women themselves control the electrical currents using a hand-held device) but TENS can also be applied to acupuncture points or directly to the head. The purpose of the review was to see whether TENS is effective in relieving pain in labour. The review includes 19 studies with a total of 1671 women. Fifteen studies examined TENS applied to the back, two to acupuncture points and two to the cranium (head). Results show that pain scores were similar in women using TENS and in control groups. There was some evidence that women using TENS were less likely to rate their pain as severe but results were not consistent. Many women said they would be willing to use TENS again in a future labour. TENS did not seem have an effect on the length of labour, interventions in labour, or the wellbeing of mothers and babies. It is not known whether TENS would help women to manage pain at home in early labour. Although it is not clear that it reduces pain, women should have the choice of using TENS in labour if they think it will be helpful.”
If you are interested in using a TENS unit for pain management in labor please check out one of these websites:
1) Transcutaneous Electrical Nerve Stimulation (TENS) for Labor Pain Relief By Robin Elise Weiss, LCCE
2) How to Use a Portable TENS Unit for Labor By eHow Health Editor
Here are some quick facts about TENS units to get you started:
1) DO learn how to use a TENS unit before labor from a trained professional. (This can usually be done by a trained doctor, midwife ,doula or physical therapist.)
2) DO continue to move with your TENS unit on! (A TENS unit does not keep you from moving around or assuming various labor positions.)
3) DO use a TENS unit beginning early in labor and if you have back pain/back labor. (Studies have shown that it is most effective in these situations).
4) DO NOT use a TENS unit while you are in a tub or shower. (Although a TENS unit can be used during times when you are not in the water.)
5) DO turn up the frequency of the nerve simulations to help with the pain of contractions or push a button to give you a “boost” as needed during labor, then turn down during periods of rest.
6) DO try turning the TENS unit off and seeing how your contractions feel if you feel the TENS unit isn’t helping. (You may find the TENS unit is actually helping!)
7) DO learn about, read about, and practice other non-pharmacological pain management techniques for labor even if you are planning on using a TENS unit including: warm water showers/bath/jacuzzi, back massage, leg massage, counter pressure, various labor positions, birthing ball, squat bar, birthing stool, visualization, affirmations, music therapy, aromatherapy, walking, warm packs, breathing & relaxation techniques, doula support, and most importantly, loving undivided attention and care from supportive labor companions.
Recommended Reading: The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions by Penny Simkin
Penny Simkin’s book is a MUST read for any woman or labor companion preparing for childbirth (EVEN women who are planning on using pharmacological pain management options including epidural and IV pain medications should read this book!!!) On page 150-151 Penny describes how to use a TENS unit in labor.
Basics:
What is TENS?
TENS stands for Transcutaneous Electrical Nerve Stimulation. By using a handheld battery operated device, mild electrical impulses are transmitted through the skin to stimulate nerve fibers. TENS is a safe, non-pharmacological method of pain control in labor and especially of back pain.
Does TENS work?
Research findings on TENS have shown that laboring women using the device use less pain medication than women using a “sham” TENS device [2]. The majority of women surveyed in the UK National Birthday Trust Survey rated it as moderately or very helpful in relieving pain and would use it again in a future labor [3]. A study that investigated the use of TENS for back pain in labor found that “TENS has a specific beneficial effect on pain localized in the back.”[1].
Purposes of TENS in labor:
Reduction of labor pain with…
- Freedom to walk and move
- Control of its use by woman or partner
- No loss of other sensations or contraction pain
- No decrease of mental function
- Continued active participation by woman
- Postponement of request for epidural
- Does not interrupt with hypno-birthing
Key Take-Away of using TENS:
- TENS is safe non-drug method of pain control for labor
- For some women, it reduces their awareness of back pain
- It seems most helpful if begun during early labor
- It is a worthwhile adjunct to other non-drug approaches for back pain
References
- Bundsen P, Peterson L-E, Seistam U. Pain relief in labor by transcutaneous electrical nerve stimulation: A prospective matched study. Acta Obstetricia et Gynecologica Scandinavica 1981; 60:459-468.
- Carroll D, Tramer M, McQuay H, Nye B, Moore A. Transcutaneous electrical nerve stimulation in labor pain: A systematic review. British Journal of Obstetrics and Gynaecology, 1997; 104:169-75.
- Chamberlain G, Wraight A, Steer P. Pain and Its Relief in Childbirth: The Results of a National Survey Conducted by the National Birthday Trust. Churchill Livingstone: Edinburgh, 1993.
Have a Blessed day
~Lisa