14 Mar TENS in labour. What is the evidence?
TENS stands for transcutaneous electrical nerve stimulation and has been used for pain relief in labour since the 70s. It is a form of pain relief that targets the nervous system, and works to block painful signals from the body. You place 4 electrodes over you lower back, and while using the TENS, a tingling sensation under the electrodes will be felt. The electrical stimulation excites nerve pathways and is said to therefore inhibit these pathways from transmitting painful signals. If the painful signals can be successfully blocked, the pain will not reach the brain, and will decrease the amount of pain experienced. Sounds great right?
It is a popular choice for pain relief during the early stages of labour as it is non-invasive and does not need other drugs which could negatively affect the mother and child. However, its benefits have been long debated.
There have been a few scientific studies which aim to test the effectiveness of TENS in labour. A study in Taiwan reported that 62% of women receiving TENS found a significant reduction in pain, while only 14% in the placebo group reported the same. Two other studies in 2007 reported that women receiving TENS were less likely to report severe pain compared to women receiving placebo or “fake” TENS, and a very high percentage of women would use TENS again in a second labour.
When comparing the studies, we see many things are done differently. For example; using TENS applied to acupuncture points on the lower back seems to show more positive results when compared to general lower back application. Also, the use of a control or placebo group is done differently across the studies. Some used a fake machine to eliminate the placebo effect and make all the women think they are receiving pain relief, even if they were not. Other studies simply applied nothing to the control group, this means these women knew they were receiving no pain relief, and therefore could psychologically believe they were in more pain, rather than just physically feeling more pain.
Overall the evidence for TENS machine use in labour is not completely clear. However, as a completely safe option, that can be commenced at the start of labour at home, it certainly can have it’s uses. Specific TENS for labour are available, which have a button you can push during contractions to change the intensity of the stimulation.
For more information about TENS as a safe and drug free option for pain relief during labour, contact us.