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Labour pain relief: TENS machine

Knowing whether TENS can actually reduce labour pain or is just ‘worth a go’ could help you to know if you want to find a TENS machine. Here’s the lowdown…

What is TENS?

TENS stands for transcutaneous electrical nerve stimulation. It’s a form of pain relief that you can control with a hand-held device. 

How does TENS work?

A TENS machine works by sending mild electrical impulses to sticky pads on your lower back. TENS is thought to work as the electrical pulses stimulate nerves that run to the spinal cord and block the transmission of pain (Doswell et al, 2009). This creates a tingling feeling. You can control the strength of the current yourself (OAA, 2019).

TENS might also work by providing a distraction and restoring a sense of control, both of which may lessen the anxiety that can delay the progress of labour (Doswell et al, 2009).

Does TENS work?

A large number of studies have found that women rated their pain similarly, whether using TENS or not (Doswell et al, 2009). But experts are not totally sure whether TENS is effective because more high-quality research about it is needed (Johnson and Jones, 2016).

Some women find it helpful at the start of labour, particularly for backache. While some use only a TENS machine for pain management during labour, it is common to use some other form of pain relief later on in labour (OAA, 2019).

Is TENS suitable for everyone?

Although the electrical pulses used are very small, some people love it, some hate it. It can't be used at the same time as water (shower, bath or birth pool).

There may be additional considerations or monitoring necessary for the use of a TENS machine if a person has a pacemaker fitted. This can be discussed with your health care provider (Badger, 2017).

What do women say about their experiences of TENS?

While most women who use TENS do so to cope with early labour at home, the research has not looked at whether it helps at this point (Doswell et al, 2009). Despite the lack of evidence for its effectiveness, many women said they would be willing to use TENS again in a future labour (Doswell et al, 2009). It’s interesting too that women said they were coping with the pain but felt more confident doing so with the distraction of a machine (Doswell et al, 2009).

Does TENS have any side effects?

While some women dislike the sensation or find the device irritating, there are no side effects (OAA, 2016).

Can TENS slow down labour?

TENS does not seem have an effect on the length of labour, interventions in labour, or the wellbeing of mothers and babies (Doswell et al, 2009).

Does TENS affect breastfeeding?

It’s not known whether there’s any impact on breastfeeding.

Does TENS have any long-term effects?

No.

What happens if I don’t like TENS?

If you don’t like the sensation or want to try a more effective method such as water instead, it’s quick and easy whip off the TENS pads and move on.

Where can I get a TENS machine?

Some hospitals provide TENS machines. If yours doesn’t, you can hire or buy one. 

Where can I use TENS?

TENS is used by labouring women at home, midwife-led units, travelling in the car, and on the labour ward.

When during labour is TENS used?

It’s usually used in early labour, and it can even be used in a car on the way to hospital (OAA, 2016).  It is not thought to be beneficial to start using TENS during strong labour (NICE, 2007).

How can my birth partner help with TENS?

The woman will need help to put on the sticky pads. It is a good idea for the birth partner to check the instructions before labour starts, and make sure you have fresh batteries. The pads will mean it’s not possible to massage the back, so you can try massaging her head, arms or legs instead if you wish. 

Can I use TENS with other pain relief?

As TENS is electrical, you can’t use it at the same time as water, and it might interfere with some hospital monitoring.  You can use TENS at the same time as Entonox or pethidine/diamorphine.

Would I need any extra procedures if I use TENS?

No.

This page was last reviewed in April 2021.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about pregnancy and life with a new baby.

Research from the Royal College of Obstetricians and Gynaecologists (RCOG) about the use of water as pain relief in labour.

Badger J, Taylor P, Swain I.(2017) The safety of electrical stimulation in patients with pacemakers and implantable cardioverter defibrillators: A systematic review. Journal of Rehabilitation and Assistive Technologies Engineering. 4: 1–9. 

Dowswell T, Bedwell C, Lavender T, Neilson JP. (2009) Transcutaneous electrical nerve stimulation (TENS) for pain management in labour. Cochrane Database of Systematic Reviews. (2): CD007214. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007214.pub2… [Accessed 5th August 2019]

Johnson M, Jones G. (2016) Transcutaneous electrical nerve stimulation: current status of evidence. Pain Management. 7(1). Available from: https://www.futuremedicine.com/doi/10.2217/pmt-2016-0030 [Accessed 17 March 2021]

NHS. (2015) TENS. Available at:  https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulati… [Accessed 17 March 2021]

OAA. (2016) Pain relief in labour: how do the options compare. Available at:  https://www.labourpains.com/assets/_managed/cms/files/InfoforMothers/Pa… [Accessed 17 March 2021]

OAA. (2019) FAQs Pain Relief. Available at: https://www.labourpains.com/FAQ_Pain_Relief. [Accessed 17th March 2021]. 

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