What is TENS?
TENS stands for Transcutaneous Electrical Nerve Stimulation & is an effective pain relief method.
It is a small, handheld/portable electrical unit powered by batteries that connect to 4 pads.
The 4 pads are sticky on one side in order to stay on the skin when placed (think of them like big plasters).
What does TENS feel like?
Once switched on, TENS feels like a tingling sensation on the skin under where the pads are.
Why consider TENS?
TENS is a very safe pain relieving choice meaning it can used by nearly everyone & pretty much has nil side effects - as soon as the machine is turned off, the effects stop.
You can apply the pads so long as the skin isn’t broken & you are more likely to have an adverse reaction to the stickiness of the pads rather than TENS itself, which the risk of is very low (so if you’re not allergic to plasters then you’re probably good to go!).
TENS is very reasonable to buy or rent if you can’t borrow one from a friend or your maternity provider & it can be used alongside other pain relief methods such as breathing, hypobirthing, staying mobile/changing positions, medications, massage, gas & air etc making it a perfect adjunct for managing labour.
How does TENS work?
TENS works by sending electrical impulses to the pads on your skin that your brain then picks up.
TENS immediately helps by activating what’s called the Pain Gate Theory - simply put, this means that as the brain can only attend to so many stimuli at once, the brain’s attention is drawn more so to the TENS sensation (as it travels very quickly to the brain) rather than the labour sensations (which relatively travels slower).
What’s more, once TENS has been worn for longer than around 45mins, it also activates endorphins to be released. Endorphins are the body’s natural feel good & pain killing hormones. The longer its worn, the more these accumulate.
Where to apply TENS
The 4 pads are applied to the back of your pelvis & middle back, either side of your spine
When to apply TENS to ensure it’s the most effective possible
For TENS to be the most effective it can be for labour, it’s advised to attach the pads & then switch it on as soon as you think you are in established labour. It doesn’t matter if you put it on & it’s a false alarm as the pads are usually reusable, so worse case scenario is you take them off & try again later/another day when you think you’re in labour again.
Where to get a TENS machine for labour from
Sometimes your maternity unit/provider will have one that they are able to loan out so always worth asking them first, and ask around to see if any friends/colleagues/family members might have one you could use. You can also buy or rent a TENS machine for labour from most pharmacies. It usually costs around £25/€30 to hire one or around £40/€50-£100/€120 to buy one. You might even be able to split the cost of a machine if you purchase one with someone that you know that is also pregnant.
Test it out before labour
TENS is perfectly safe to use on your arm or leg at any time if you are keen to test it out before labour. This is really valuable to do so that you know what it feels like and so that you make sure you confidently know how to connect it up & switch it on - you don’t want to have to be worrying about unpacking/connecting it up for the first time when you are in labour!
Buy fresh batteries (they usually take 2 x AA) to make sure it doesn’t run out when in labour & have new spare batteries close by just in case.
Buy new pads for labour (4 x large rectangular - 40x100mm each) to make sure they have the most effective adhesive possible - the better the contact with the pad on your skin, the more effective it will be. (if you feel the stickiness is lessening at any time, just put a few drops of water onto the pads & it'll make them stickier again)
It’s possible you might be on your own when early labour starts, depending on your location and the time of day, so make sure you have practised putting the pads in the right location on yourself.
If you are having a birth partner, teach them where the pads go too so that they can help if needs be.
How to use it during labour to ensure it’s the most effective it can be:
TENS works most effectively the earlier in labour you put it on and the longer you have it on for (so put it on as soon as you can & don’t take it off!)
Once the 4 pads are in place, switch the machine on & turn the 2 channels down to the lowest setting (each channel connects to 2 pads).
You should feel an intermittent pulsing/tingling/buzzy sensation on the skin where the pads are. You will feel this continuously whilst the TENS is on & working.
At the start of each contraction, push the ‘boost’ button. This will change the TENS to deliver a more intense & constant electrical impulse that helps to manage each contraction.
Once the contraction is declining/has passed, hit the boost button again and it will go back to the lower intensity intermittent mode.
‘Accommodation effects’ are normal which means you’ll have to gradually keep turning up the intensity of the channels as labour progresses to keep up with the increasing power of labour. This is a crucial part to ensure TENS stays effective.
When to take it off
The only down side to TENS is that, as it uses an electrical current, you can’t use it in water. So if you are going to get in the bath/shower/pool then you have to take it off. Other than that, do not let anyone take it off without your consent. TENS loses its effectiveness if it’s taken on & off. Sometimes people will take it off thinking it’s not doing enough but then realise it is helping once it’s been taken away and it’s then really hard to catch back up to where you were with it. If you can, plan to put it on & keep it on. It’s totally safe to use for the whole of labour (the build up, delivery of baby and delivery of placenta), no matter what happens and no matter how long it goes on for. It also won’t interfere with any monitoring if you or baby require this.