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What is TENS?

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TENS is a drug-free form 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.

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How does a TENS machine work?

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We don’t know exactly how TENS works 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

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When should I use TENS?

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You should use TENS from the very beginning of your labour. It works most effectively from early on to build endorphin production.
 

 You may need to temporarily turn the TENS off if your baby's heart has to be monitored electronically, because the electrodes could affect the signals to the monitoring machine (however, usually it does not interfere).

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How should I use TENS?

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Your birth partner or Midwife can place the pads on your back for you.

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• 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.

• 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?

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

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• Before you reach 37 weeks of pregnancy (unless you are in pre-term labour and baby is on the way).

• 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.

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What are the advantages of TENS?

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• 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 or hospital 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?

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• You probably won’t be able to put the pads in place without help.

• TENS can’t be used in water, though you can still use it before and after you get in a bath or birth pool.

• If you want your birth partner to massage your back, they may have to work around the pads.