Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

Research Shows TENS Unit Can Ease Labor Pain May 15, 2009

It’s been waaaaaaaaaaay too long since I have posted!  It’s been really crazy busy at work and I’ve had to work some overtime to help out.  But I’m back in the saddle again!  So here it goes!

 

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Medical News Todayrecently 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.”

 

I think the findings of this study are interesting.  I certainly support pain management techniques in labor that 1) are non-pharmacological, 2) do no harm to mother or baby or to the progress of labor, and 3) increase a mother’s feeling of control during her labor.  So it seems like the use of a TENS unit could be really helpful to some moms.  On the other hand I have never had any experience with a TENS unit, either personally or via any of the moms I have taken care of, so I have little knowledge about it. 

 

Since I have little knowledge on the subject I naturally did an Internet search to learn more.  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, 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. 

 

Are you looking to rent a TENS unit for your labor?  Please check out www.babycaretens.com

 

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Have any of you ever used a TENS unit for pain management in labor?  I’d love to hear how it worked for you!

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27 Responses to “Research Shows TENS Unit Can Ease Labor Pain”

  1. Johanna S Says:

    I did not use a TENS during my daughter’s birth, but I am looking forward to learning more about it if we choose to try for #2. I just came across your blog last week. I can’t describe how ecstatic I was to find it! Thank you for taking the time to share all this very useful information with us and for sharing a different perspective, the perspective of a nurse who is at an L&D floor day in and day out seeing it all.

    • nursingbirth Says:

      Johanna S, I am so excited you are enjoying my blog!! Please spread the word to all your friends and family who have or want to have children! My blog is dedicated to all the moms out there like you searching for more information!! KUDOS to you!!

  2. I really wish that TENS was more available to laboring women, bot in their knowledge base as well as in the labor and birth units. Thanks for raising the awareness.

    • nursingbirth Says:

      Robin Elise Weiss, thanks for commenting! Your article was one of the only articles out there on the web for TENS in labor. Thanks for writing it! I certainly learned a lot! How did you get involved writing for about.com?

  3. I find this fascinating! I have zero experience with TENS units in OB, not even a whisper of it mentioned in research meetings etc. It sounds a little creepy to be honest, yet so does sticking a needle in your spine! If it works and causes no harm to mom and baby, bring it on. Sounds like a lot more research needs to be done however. I also agree with you, that all women should learn about natural pain relief measures, even if you want a medicated labor. It will make you feel more in control.

  4. Amy Says:

    23+ years ago my mother used a TENS unit to deal with the pain after her C-sections with all three of her children. I do not know how affective it is in labor, but I have heard nothing but good things about how it helped her and made recovery a breeze. I am due in July and will be asking my doctor if this is something my hospital has available to use during labor.

    • nursingbirth Says:

      Amy, thanks for sharing your mom’s story! I have heard of TENS being used for chronic and post-op pain as well so I can see how it might be used for a C/S. If your hospital doesn’t have any TENS units for moms to use, perhaps you could rent one! Thanks for reading!

  5. Megan Says:

    I used a TENS unit during my second labor and it helped me avoid pain medications after a complicated epidural birth the first time around. It was fabulous! I’m now a doula and it’s a crutial item in my bag of tricks. Laboring moms absolutely love it! I have never come across anyone who didn’t like it and everyone says to me afterwards that they never could have made it through without it. I have the Babycare Elle TENS with the labor boost function. I had to order it from the UK. I don’t understand why this option isn’t more well known or readily available in the US.

    • nursingbirth Says:

      Megan, a double whammy! Not only have you used it, but you offer it to your moms as a doula!! Wicked cool! Thanks for the info and for sharing your story!

  6. Amy Romano Says:

    Great post. I have been aware of TENS for labor pain but never used it (in labor myself or on my midwifery clients). I know its much more popular and available in other countries. I’ve been thinking about TENS a lot, because my chiropractor puts me on the TENS unit every time I go in and I LOVE it and I could really see how it would help with labor pain – mostly in its ability to distract a woman from the pain, or possibly confuse the muscles/nerves and change the way pain is perceived or transmitted. My midwifery practice is going on sabbatical in 6 weeks. Otherwise, I think I would consider buying a TENS unit to bring to births.

  7. Birth_Lactation Says:

    Melissa, Great info- I missed you! I have not seen TENS units in our L&D. I have personal experience. I had a back injury in the late 80’s. A disc out @ L5S1 with free disc fragments (that were later found to be ADHERED to my R sciatic nerve root! )Talk about pain. I used a Tens unit many times in the 3 1/2 years from injury to surgery. It was never used in the most acute pain flare-ups. I would have epidural steroids and used a Tens along with PT when the pain level went down. I remember it was very helpful for muscle pain, muscle spasms but not directly for the nerve pain. I don’t know if that was anyone else’s exp. I will have to look in on these studies. I am an extremely successful fully recovered post laminectomy pt. (17yrs now)
    Very interesting. Thanks so much…
    The other Melissa

    • nursingbirth Says:

      Birth_lactation, I’m glad to be back! Haha! I anticipate some type of back problems as I get older….being 5’10” in a much smaller person’s world I already suffer from back pain at just about 26 y.o. …..YIKES!! I guess I should start looking into a TENS unit now!! Thanks for sharing your personal experiences with the TENS. My L&D doesn’t have any either so I too am interested in reading more about it! P.S. I’ve been reading your blog a lot…LOVE the stories about surprise twins!!

  8. Birth_Lactation Says:

    In case you didn’t know…
    The Other Melissa is me 🙂
    Birth_Lactation
    http://obnurse35yrs.wordpress.com/
    😉

  9. Renee Says:

    My OB office had these available. According to the childbirth educator they were the only office in the US that had them. Don’t know if it’s true or not. She said they are common in England and they had a lot of women from there that were requesting them, so they have a few. I didn’t use one because we were told they were for, and most effective when started during prodromal labor. My cx started at 2-3 minutes apart, so we didn’t really expect my labor to end up being 37 hours! But apparently other Moms in the practice LOVE them.
    PS I have started “Silent Knife”. As shocking as they make the stats sound back then, it makes it more so knowing what they are now! I read the chapter of letters and had to put it down for the night, it hit close to home. I wonder how some OB’s would feel hearing how a lot of Moms feel down the road, not in the hospital. It seems, and is so for me, that it was ok at first and I got sadder and madder over time.

  10. Stephanie Says:

    I am loving your blog! I had a terrible experience with my epidural during my first labor/delivery. After months of counseling (complications resulted in nursing issues and PPD), I am on a mission to educate myself so it doesn’t happen again. I have been looking for alternatives for the next baby and the labor/delivery. Thank-you for all the wonderful information!!!

    • nursingbirth Says:

      Stephanie, I am SO HAPPY that you are on a “mission to educate” yourself this time around. It is corny but “knowledge is POWER” haha! Thanks for reading!

  11. Birth_Lactation Says:

    Thanks Melissa– I just did a story about keeping a secret for years about an adoption..
    http://obnurse35yrs.wordpress.com/
    You are young girl! My son will be 30 yrs old on Monday- Yikes for me! Use those body mechanics and don’t hold heavy epidural legs with pushing if you can avoid it!

  12. Many doulas have gone through an advance doula training (thanks Penny Simkin for starting this initiative) and use TENS units. Unlike the one that Amy uses at the chiro. office there are models specifically designed for women in labor. I purchased mine from England. So check with your local doulas to see who offers that as a support technique.

  13. sarah Says:

    We are the same age and height and both obsessed (do you mind me saying you are obsessed) with birth…maybe we are surprise twins. LOL.

  14. I used a TENS during labor with 2 of my deliveries. I ordered a book written by Dr. Gordon Gadsby titled “A women’s guide to drug free pain relief.” My midwife had never heard of using TENS before, and the nurses in the hospital were amazed. From my research, this is popular in the UK.

    • nursingbirth Says:

      Amanda Thomas, thanks for sharing experience with a TENS and for letting me know about that book! I’ll have to put it on my “to read” list! (Oh my “to read” list grows every day!!)

  15. Katherine Says:

    I adored my TENS. Started off prodomal laboring, was checked after some 8 hrs of gastro pain, regular contractions, though 7mins apart or so. @2 cm, I was a little discouraged, but my midwife asked if I’d used the TENS she provided yet, and I said no, because it wasn’t back labor. She told me to give it a try anyway, so we stuck it on, and then I spent the night listening to my Hypnobabies CDs and using the TENS. In the morning, she came over and she said I was a stretchy 4, and so we settled down for the labor! I have to say, I thought the TENS was much more useful in pain management than the warm pool, which I know is unusual, but if I get pregnant again, I’m totally buying one!

    I ended up getting stalled at 8 cm for something like 8 hrs, which is probably due to him being asynclitic from his double nucal. We broke my water to see if I could get stronger contractions, and there was mec, so we transferred to the hospital. Thankfully, the decels recovered quickly, and the OB backup quite calm, so I didn’t automatically get cut. We did get the vacuum for the last bit as I started pushing almost immediately upon arriving at the ward, and he was having some terminal brady. The double nucal could have been the reason, but he also had a true knot!

    I’ll have to send you a complete birth story someday, if you’re interested, but it was really interesting to be an L&D nurse and also a laboring woman. A little surreal.

    I highly recommend TENS even if they’re not the end all be all! Hypnobabies was also helpful to get me in the labor head-space, but it was hard not to find it a bit cheesy. I do not begrudge the cost of the course at all.

  16. Great post. I have been aware of TENS for labor pain but never used it.


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