Labor pain is a personal experience in pregnancy and childbirth and each woman will have their own reaction to labour pain. Many pregnant women look for other solutions that can make it easier for them to feel comfortable and active as they go through the birth process. A non-drug option suggested is TENS Therapy for Labour using gentle electrical stimulation via adhesive pads attached to the skin. A tens machine for labour can be used as a component of a comprehensive pain management strategy, especially in the early phases of labour.
Transcutaneous electrical nerve stimulation (TENS). It sends tiny electrical shocks to the body via electrodes that are typically positioned on the skin around the lower back while the person is in labour. Typically, it feels like a tingle, not a pain to the stimulus. This is a non-invasive technique that doesn't involve medication and some women like the fact that they can choose the level of stimulation for themselves. It is vital to note, however, that TENS does not always provide a woman with total pain relief and is more effective for some women than others.
So, what is TENS therapy for labour?
TENS Therapy for Labour is the term for using transcutaneous electrical nerve stimulation to aid a woman in managing the pain associated with labour. The device is generally small, portable and battery operated. The handheld unit is fixed to the skin with adhesive electrode pads. It becomes active when turned on, and delivers low-level electric currents via the pads, inducing a mild tingle.
The exact way TENS provides pain relief is not completely understood. It is believed to affect how pain signals are conveyed in the nervous system and can stimulate the body to produce natural pain killers known as endorphins. Some women may find these effects to make contractions or lower-back pain more manageable.
How to use TENS for Labour?
As labour progresses the uterus contracts and the cervix progressively dilates as the body gets ready for birth. Pain may be experienced in the abdomen, pelvis, lower back or other areas. Another sensation that can be achieved with TENS is electrical stimulation, which can be used to turn down the sensitivity to pain signals.
There is one theory that explains this phenomenon, called the pain-gate theory. The electrical stimulation stimulates some nerve fibres and can disrupt pain transmission or pain perception to the brain. TENS also releases endorphins, which can help the body to deal with discomfort naturally. The scientific research specifically concerned with the use of TENS for pain relief during labour, however, is limited, and it is more correct to say that TENS is a possible method of comfort and coping during labour rather than a guaranteed one for pain relief.
TENS is frequently used in early labour, for which reasons?
TENS could be beneficial especially in early labour or latent phase. At this point, there might be mild back pain and contractions may start to become more frequent and stronger. The use of TENS is recommended in the early stages, especially when lower back pain is involved, but it has not been proven to be effective when contractions are longer, stronger and more frequent in the active phase.
Early use of TENS could also allow the mother to be familiar with what it feels like before labour gets more vigorous. Some maternity services suggest learning how to use this device in the later months of pregnancy, so that the mother knows how to operate the device and where the pads go. Talk to a midwife or doctor beforehand about using it during birth ensures that it is suitable for the person's birth plan and pregnancy.
Helping to establish a sense of control
It has been one of the important advantages for TENS Therapy for Labour that the lady can typically control the intensity of stimulation as she can. It can have a calming effect to have something in your control, especially if your contractions start happening erratically or when they are uncomfortable.
A woman can dial down or dial up the stimulation to her own comfort, which may help her feel more involved in her labour. Therefore, TENS might be considered a component of a more comprehensive program, which can include breathing exercises, movement, massage, relaxation, water-based comfort measures (when appropriate), and medical pain-relief remedies (when required).
NHS guidance also makes it clear that women should be able to talk with their maternity team about their choice of pain relief, and can change their mind about it during labour. A birth plan can be used to give guidance but does not need to limit options if there are changes in the circumstances or personal preferences.
This is a Drug-Free Option for Labour Comfort
Another reason why women might want to use TENS Therapy for Labour is that it does not involve using medication. If women prefer to start using non-pharmacological comfort measures, they can consider TENS as one of these options and discuss it with their health care provider.
TENS is non-invasive and external, so there's no injection or medication. It can also enable a woman to keep moving around when operating the device, depending on the policies of her maternity unit and her personal situation. This can be helpful as movement such as changing position, walking, or other movements may help women cope during labour as well.
But not all pregnant women can use TENS. Advice from the NHS suggests pregnant women should only use TENS after proper advice from a doctor or midwife. If you have some medical conditions such as epilepsy or a pacemaker, please get medical advice before using TENS.
The discomfort of the lower back and tens
Lower back pain may be significant during labor and is another area where TENS may prove to be useful. Electrode pads are typically applied on the bottom of the back during labour, following the manufacturer's guidelines and according to the advice of a healthcare worker.
The stimulation may give the woman a competing sensation that helps her to concentrate on the "tingling sensation" as opposed to the "whole discomfort. Some women might like to use the handheld controller themselves and their partner or birth support person can offer encouragement, massage or comfort.
Don't assume that increased electrical stimulation will always be more relieving. The intensity should be increased or decreased based on comfort and manufacturer's directions. A healthcare professional could show you how to use the pads and pad positioning before giving birth.
Will TENS really make labour pain-free?
It is crucial to have realistic expectations of TENS Therapy during labour. TENS is not a technique that will completely remove labour pain. A Cochrane review provided some weak evidence that TENS may help relieve pain during labour but there was not much difference between those using TENS and those who were not on overall pain ratings. There was also no consistent effect found on the length of labour, labour interventions and maternal and newborn wellbeing following the review.
This does not mean that TENS is not useful. Everyone experiences pain differently and some women may find the stimulation helpful to cope, distract or keep them in control. NHS maternity information also states that TENS can be used as a pain relief technique during early labour, but may be less effective during late labour.
Therefore, TENS should be thought of as one comfort measure among many when considering methods to alleviate pain.
Using TENS together with other comfort techniques
There is the potential for TENS to be used as part of a more comprehensive labour comfort plan. She can use it in conjunction with controlled breathing, relaxation, movement, massage or any other methods suggested by her maternity team. The aim of labour pain management is to keep the mother mobile, to change her position, use breathing techniques, massage and water, according to the NHS guidance.
This is a flexible method which may be useful as labour can quickly change. The woman may start with non-drug treatments and then choose a further treatment if she feels she still requires some form of pain relief. It does not mean that other options, e.g. gas, air, injections, an epidural cannot be considered if medically suitable and available if chosen to use TENS.
Is TENS Safe During Labour?
There is no known evidence that TENS will harm the mother or baby when used correctly during labour and can only benefit the baby. Women should only use TENS if they have discussed it with their midwife or doctor as this is a medical circumstance in which medical guidance is important.
TENS should not be used in water (bath or shower) and the electrodes should never be placed on broken, infected or irritated skin. It should also not be used at night while sleeping. Always follow the directions given with the device.
Women need to also review their maternity unit's policies as the equipment and procedure may be different in each hospital. Sometimes TENS can be used during specific phases of labour, and sometimes there are circumstances where TENS is not compatible with the other monitoring or procedures.
TENS preparation for labour
Using TENS can be more comfortable if you are well prepared. If you're thinking about using it, talk to your midwife, doctor (OBGYN) or other healthcare worker who sees women who are pregnant. They can advise you if it is suitable, and show you how to position the electrodes.
Familiarity with the device prior to labour can also be helpful. Knowing how to operate the controls and the battery needs, as well as where the electrodes are placed and the manufacturer's guidelines can make contractions a less stressful experience. When buying or renting a piece of equipment, be sure to select a reliable source and make sure it is meant for the purpose you are using it for.
It doesn't mean that you have to use the device during the entire labor, but it is available for your use if you want to have one. You're able to talk to your birth team and decide based on your current feelings.
What are the biggest advantages of a TENS machine during labour?
TENS provides a number of practical benefits for some women. It will not require any surgery, medication, and is generally self controlled. It can offer a beneficial feeling that aids coping, especially when getting ready to start labour and if the lower back is bothering. Also, it may permit movement as per the specific situation and policies of the maternity unit.
Another upside is it can be integrated into the birth plan. There are differences between the expectations and preferences of women for labour pain management and having multiple options can help offer flexibility. However, the effectiveness of TENS is not consistent and studies have not proven that it is a very effective labour pain management technique for all women.
Here are some things to keep in mind about TENS
The most critical is that TENS must be considered a comfort/coping measures not pain elimination. May be especially useful in early labour, may be less effective as labour progresses and contractions become more intense.
Prior to use of TENS, ask your maternity healthcare provider for advice, and learn how to use the TENS safely and correctly, and when it should not be used. Be aware of other options for pain management so you can make adjustments if your pain management plan changes during labour.
Conclusion
TENS may be a good non-drug choice for women who need extra help to deal with discomfort in labour. TENS Therapy for Labour might be beneficial in early labour for low back pain, and it's less clear whether it can help to alleviate pain in active labour. It is easily transportable, can be stimulated by the woman herself and is non-invasive, which makes it a conversation worth considering as part of an individualised birth plan.
Finally, each labor experience is unique and there is no one pain-management solution that works for all women. Therefore, TENS Therapy for Labour should always be considered along with other comfort and medical pain relief options. Ask your midwife or doctor before using TENS while pregnant or during labour; use it as directed; be flexible in your pain-management approach as indicated by your needs and your maternity team.
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