TENS Unit: The 'Natural Labor' Tool No One Is Talking About

Find out how a TENS machine works and if this drug-free labor pain management tool could be an option for you.

Chances are you've never heard of TENS, which stands for transcutaneous electrical nerve stimulation. This portable, non-invasive, labor pain relief option has been in use since the 1970s to treat acute pain, including during childbirth, although its use during labor is rare here in the U.S. However, if you're interested in non-pharmaceutical comfort in labor, TENS can be a terrific, low-risk option for you and your birth. Here's what you need to know.

What Is a TENS Unit?

Introduced into maternity care in Scandinavia in the 1970s, a TENS unit is a handheld machine connected by wires to electrodes that stick to the skin on your back.

TENS works by sending electrical nerve stimulation through these electrodes; it doesn't take away the sensation of contractions but essentially interrupts the pain signals your brain is receiving, possibly reducing your awareness of them or producing endorphins that allow you to cope better. It's a familiar comfort measure used in physical and occupational therapy, especially by people who deal with chronic pain issues.

Why Are TENS Machines Uncommon in the US?

So why is this alternative pain relief option so uncommon here in the United States? Eileen Ehudin Beard, a certified nurse midwife and senior practice adviser at the American College of Nurse-Midwives, says, "Complementary and alternative ways to provide comfort are not thought of as first line here in the U.S."

Anthony Scialli, clinical professor of obstetrics and gynecology at George Washington University School of Medicine, adds that "obstetrical traditions here are centered around the use of epidural for pain relief in labor." In other words, Americans aren't used to relying on non-pharmaceutical methods for comfort in childbirth, not because they aren't effective, but because the system doesn't support them. TENS units for obstetrical use are difficult to find in the U.S. Many medical professionals are unaware of TENS and/or have never seen one used by a birthing person.

What Are the Downsides of TENS?

There aren't many downsides to using the TENS during birth other than its effects can vary widely from person to person. Studies are inconclusive regarding exactly how and why it works and why it might work very well for some people and not for others. Still, in a Cochrane review of evidence regarding TENS, most birthing people who used it said they would use it again in future labor. TENS is not recommended for people with pacemakers, and it can't be used while you are in a shower or a bath (or once you get an epidural).

What Are the Benefits of Using a TENS Unit?

TENS units are great because, during labor, they allow you to remain active and upright—you can labor with a TENS in any position you want. The feeling that comes through the electrodes is like a light buzzing or prickling, but the unit has buttons you can use to turn the intensity up or down, depending on your pain level, tolerance, and where you are in your labor. TENS usually does not interfere with electronic fetal monitoring, so it's OK to use when laboring in a hospital setting.

TENS can be a powerful means to avoid pharmaceutical pain relief if that's your goal, or it can be a tool to lessen discomfort during early labor or while you wait for an epidural. Many people find it mentally beneficial as another sensation to concentrate during contractions. In many ways, TENS can help you feel more in control of your labor experience.

The benefit of rest between contractions

Stephanie Bieniarz was already familiar with TENS during her studies as an occupational therapist, so she was open to using it when her labor was longer than expected. She says of her experience: "During hour 12 of what ended up being 50 total hours of labor, my doula encouraged me to try using TENS to assist with back pain. I agreed as I was eager to try pain management treatments that were non-invasive. The TENS allowed me to rest a bit as labor progressed; I even slept in between contractions when I had it on! It gave me enough of a mental edge over the pain that I felt I could manage to birth without pain medicine."

The benefit of being in control of your labor experience

A certain level of confidence and control comes with knowing what to expect. When it comes to using a TENS unit effectively, knowing the ins and outs of the machine itself may be a way to increase your level of control during labor and delivery.

Beard notes that birthing people can increase the efficacy of TENS by understanding how it works and becoming familiar with the tool before they use it while birthing. "The women who seemed to have the most success with pain relief in my practice were women who used TENS during their pregnancy and were familiar with it. They were then very comfortable using it during labor."

Other benefits of using TENS during labor

Reducing pain during labor significantly enough to rest between contractions is pretty enticing, but there are other benefits too. These benefits include:

  • TENS units do not require a medical professional to operate—you could use one to give birth at home.
  • There are no side effects on your baby.
  • You can put it on or off at any point during labor.
  • TENS is thought to be beneficial for back labor.

The TENS may appeal to people planning an unmedicated birth and those who want multiple pain relief options during their labor. Jessica Fuqua, a family nurse practitioner in Alburquerque, New Mexico, who used the TENS as she labored with her second baby, says, "I was so glad I was able to use the TENS. I used it once my contractions got to 6-7 on the pain scale for me, and it was comforting to know I could turn on the unit at the start of my contraction as another coping mechanism to deal with the pain."

How do you get a TENS unit?

If you want to use the TENS unit during birth, you'll likely have to seek one out yourself or find a doula who offers one as part of their care. If you buy or rent one, make sure it's a TENS specifically for pregnancy and birth—TENS units designed for other uses aren't appropriate for pregnancy.

It would be best if you also discussed your intention to use TENS with your provider and the people who will be present at your birth, too—making sure everyone is on the same page about pain relief options would make for a more straightforward communication process once you're actually in labor. Whether you try this little-known choice, becoming informed about TENS and your other options for pain relief will help you feel knowledgeable and empowered during your birth experience.

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