So, you keep hearing word of this mysterious TENS machine that people use in labour, but what on earth is it? Is it a magical drug free alternative to an epidural? Tens, as in something between nines and elevens?
What is TENS?
TENS stands for transcutaneous electrical nerve stimulation, which is electrical pulses applied through your skin. It is a non-pharmacological pain relieving technique.
A TENS machine is a small machine with sticky electrodes that attach to your body and has applications for pain relief in various areas of the body.
There are specifically made TENS machines that are for use in labour, which we hire out at FitRight HQ. Unlike traditional TENS machines which are used at a constant level, these 'Labour TENS' machines are used constantly at a strong but comfortable level but then have a ‘boost’ button that can be pressed during a contraction to give an extra ‘kick’.
How can TENS help with labour?
TENS helps to control the perception of pain. It also allows for women to stay active during labour and to have some control over their pain modulation.
How does it work?
One theory of how it works is called the ‘Pain Gate Theory’.
The 'Pain Gate Theory' is all about how the brain is not a fantastic multi-tasker - only a certain amount of stimuli can be processed by the brain, and the system has the 'shut the gate' on the remaining stimuli.
We only feel pain because the brain interprets signals and tells us we are experiencing pain. If the brain is receiving pain signals from labour contractions, while also being flooded by the sensory buzzing feeling from TENS at the same spinal levels, it can’t entirely focus on interpreting the pain.
For example, what do you innately do if you hit your funny bone hard? Probably, you grab your elbow and put pressure on it, rub it, or shake your arm. We do this because the brain is getting the pressure, rubbing, or shaking information at the same time, and this may dampen down the amount of pain we are interpreting.
So in labour, the theory is that if we put two pairs of electrodes delivering TENS, one at the level of the nerves going to the uterus (approximately just below bra strap
level) and one at the level of the nerves going to the cervix and vagina area (roughly where the dimples are in your lower back), then the brain is going to be focusing on interpreting those messages as well as the labour pain.
It’s interesting to note that some practitioners choose to deliver TENS in labour to acupuncture points instead of directly over the nerves on the lower back.The bottom line is that this is not a ‘pain relief’ option, like an epidural. It doesn’t take away the pain. Instead, it’s a ‘pain distraction’ option. Similar to breathing, movement, and positioning strategies taught in active birth workshops and Hypnobirthing courses.
Is there any evidence for it?
Historically, there hasn’t been strong evidence for the use of TENS in labour.
However, there was a positive outcome in a study from 2021, where they investigated the use of TENS in 326 women, in the first stage of labour versus routine care. The group of women who used TENS had significantly lower pain scores at the 30 minute, 60 minute and 120 minute mark, compared to the control group. Those that used TENS also had a statistically significant shorter active labour duration, compared to the control group.
In a 2010 Systematic review of 14 studies, there was little difference in pain relief or ratings between those that used TENS and those who didn’t. Interestingly however,
the majority of women who used the TENS reported that they would use it again in future labours. No adverse effects were reported for the use of TENS.
There have been no studies that showed any negative outcomes to the mother or baby with the use of TENS, and most guidelines that I’ve seen say that women should be given the choice by their healthcare team to use it during their labour, among all of their other choices.
In our experience working with the perinatal population, women have told us that they like the sense of having control over something, and they liked the ability to turn it up as their labour progressed and intensified. Many have told us that they weren’t sure if it was doing anything, but then they needed to take the machine off to go in the bath or to have an epidural inserted, and it was then that they realized the difference in intensity of what the contractions felt like without the TENS.
How do I get hold of one?
We offer TENS machine hire right here at FitRight HQ, along with TENS demonstration consultations to help you feel confident using your machine during labour.
A TENS consult can also be included as part of a longer Preparation for Birth appointment.
The total cost includes the physiotherapy consultation fee, weekly machine hire fee, and the cost of the electrode pads (single-person use only and yours to keep). Private health rebates may apply to the consultation component where eligible.
Click here for information on our hiring process.
What does a TENS consult involve?
If you only wish to hire the TENS machine without any other input from the physiotherapists, it is a 15 minute consultation to go through the list of steps below and ensure you are confident and safe with it's use.
Alternatvely, TENS hire can be included in a birth preparation consultation (30 -60 mins). Preparation for birth may include a Pelvic Floor Muscle assessment, support wear fitting and education and advice about postnatal rehabilitation.
It is recommended to hire from 38 weeks onward, for a 4 week period.
- Education on how TENS works.
- Checking for contra-indications or any precautions.
- Instruction of where to place electrodes and how to set up the machine (including plugging in the leads and using the booster button).
- Demonstration of how the TENS feels on the forearm.
If you would like to book a TENS consult or read the FAQ's, you can do so here.
