When it comes time to deliver her baby, a woman has traditionally had only two options for pain management.
She could opt for unmedicated childbirth, or she could choose medication.
Now, a third option is possible: using transcutaneous electrical nerve stimulation, or TENS, to relieve pain.
A recent study found limited evidence that a TENS unit could reduce labor pain, but they also found that there were no negative impacts on the mothers or their babies.
The mothers in the study who used TENS units said they would be willing to use the TENS units during subsequent deliveries.
TENS units are used widely in other fields of medicine. The unit itself is a small device used to emit low voltage electrical pulses that are carried through electrodes to various locations in the body. The exact mechanism by which the pulses reduce pain is not understood.
It is believed, however, that the pulses stimulate nerve pathways in the patient’s spinal cord, which blocks pain. During labor, the electrodes can be placed on the patient’s lower back, or on acupuncture points, or even on the patient’s head.
The meta-analysis looked at studies involving more than 1600 women in 11 countries, including 3 studies in the U.S. They looked at a variety of factors. For example, to test the placebo effect, the use of a functioning TENS unit was compared to a non-functioning or sham unit.
The use of TENS units was compared to routine care using other types of pain management, including medication and other non-medical techniques. They also looked at whether or not the placement of electrodesâ€”on the back, head, or at acupuncture pointsâ€”made a difference in pain relief.
Results were inconsistent. Some women using TENS units reported less severe pain, while others did not. Some women using TENS units said they were satisfied with the amount of pain relief they received, while others did not. There were no clear evidence-based conclusions.
However, since the units did no harm and did help some women, researchers concluded that the use of TENS units should be given to women as an option for relieving the pain of labor and delivery.
Obstetricians are generally supportive of any pain relief method women choose so long as there is no harm to the mother or baby, and local hospital policies will allow it.
In some studies the TENS units were not used as the sole method of pain relief, but as an adjunct to other forms of pain relief, such as an epidural.
During an epidural, anesthesia is injected into the epidural spaces of the spinal column; epidural injections are the most common form of medication used for relief of pain during labor and delivery.
TENS units are not readily available in most labor and delivery units. Their use is generally not covered by health insurance for labor and delivery. However, the units are relatively inexpensive to rent should a woman want to have one available to her.
The best time to discuss options for managing the pain of labor and delivery is no later than the middle of your pregnancy. This gives you plenty of time to weigh all of your options and prepare for the kind of birth you want. An increasing number of women are choosing to give birth without pain medication.