NatalCare Labour Tens Machine Instructions

: September 25, 2024
: NatalCare

Table of Contents

WHAT IS TENS?
HOW TO USE A TENS?
HOW EFFECTIVE IS A TENS MACHINE?
WHAT ARE THE BENEFITS OF A TENS DURING LABOUR?
HOW DO I GET THE MOST OUT OF MY TENS?
WHERE DO I PLACE THE ELECTRODES?
WHERE DO I GET A TENS UNIT FOR MY BIRTH?
SAFETY GUIDELINES
Documents / Resources

The Complete GuideThe Complete Guide
to Labour Tens

As your due date approaches, you’re likely considering your options for pain relief during labour. If you’re planning a drug-free, natural birth without medical intervention, a Labour TENS machine is a valuable tool to include in your toolkit of natural pain relief strategies.

WHAT IS TENS?

TENS or Transcutaneous Electrical Nerve Stimulation is a powerful, non- invasive pain relief tool, trusted by midwives and widely used by women across New Zealand and throughout the world. While being natural and drug-free, TENS also allows you to remain mobile during labour and maintain personal control over your pain relief.
A TENS machine is a small battery-operated device that works by delivering small electrical impulses to your body through four sticky electrode pads attached to your lower back. These impulses cleverly ‘trick’ your brain by flooding your nervous system, reducing its ability to transmit pain signals to your spinal cord and brain. TENS has often been described as a ‘Contraction Distraction’ device.
MIDWIFE APPROVED

https://www.tenshire.co.nz/pages/the-complete-guide-to-labour-tens-video

“The TENS machine allowed me to control my own pain how and when I needed it. The TENS was the one thing that empowered me to give birth naturally even though that wasn’t the birth plan I had in mind!”
Words from Lauren

WHY TENS WORKS?
THE PAIN GATE THEORY AND HOW TENS WORKS BY CHANGING HOW YOUR BODY PERCEIVES PAIN
TENS operates on a principle known as the Gate Control Theory of Pain. To explain this simply, imagine that your spinal cord functions as a gatekeeper for pain signals travelling to your brain. When you experience pain, such as the intense pains during labour contractions, these pain signals are sent from your uterus to your spinal cord and then on to your brain, where they are perceived as pain. TENS helps ‘close the gate’ on these pain signals. It does this by stimulating specific nerve fibres, particularly the large A-beta fibres responsible for transmitting sensations like touch and pressure. When these fibres are stimulated by the electrical impulses from the TENS machine, they effectively block the pain signals from reaching your brain. This can significantly reduce your perception of pain during a contraction. Additionally, TENS also encourages your body to release endorphins, which are your body’s natural painkillers. These endorphins are our body’s own natural supply of morphine and they help to ease pain naturally and safely. By starting with the TENS machine early in labour and gradually increasing its intensity as contractions intensify, you can maximise the release of endorphins and improve your pain management.

HOW TO USE A TENS?

Labour TENS machines are compact, portable, and very user-friendly. They should come with four sticky electrode pads that you attach to specific points on your lower back. The control unit is easy to operate, allowing you to adjust the intensity of the electrical impulses according to your comfort level and the stage of labour you’re in. Once you’re sure you’re in labour, set up your TENSmachine and have your birthing partner place the electrodes on your back. Applying the TENS early in labour allows you to get familiar with its sensation and gives time for endorphins—your body’s natural pain relievers—to build up. Starting the TENS sooner rather than later ensures you get the maximum benefit from endorphin release. TENS machines come in various models, but all ‘obstetric’ or ‘labour’ TENS machines function similarly. They typically feature dual settings: a higher ‘boost’ setting for use during contractions and a ‘rest’ mode for the intervals between contractions.
Before turning on the TENS machine, ensure the BOOST button is switched to the ‘off’ position. Start with the intensity for both settings on low and gradually increase the intensity, as and when you need it. One of the biggest advantages of having your TENS machine ready for labour is the immediate pain relief it offers when you need it most. You can use it comfortably at home for as long as possible before heading to the birthing suite or hospital. For homebirths, it can be paired with other natural methods, while for hospital births, you can use it on the drive to the hospital, and keep it on throughout labour. TENS works seamlessly with other pain relief techniques like hypnobirthing, breathing exercises, or a birthing ball, and can be alternated with time in and out of the birthing pool. Its portability allows you to stay active during labour, which can contribute to shorter labour times, fewer medical interventions, and better overall outcomes.

HOW EFFECTIVE IS A TENS MACHINE?

Recent research has compared the effectiveness of TENS to no pain relief or epidural options during labour. Findings consistently show that over 80% of women who used a TENS machine during labour would choose to use one again in future births. This suggests that most women experience relief or distraction from contraction pain with TENS. The significant increase in demand for labour TENS units over the past 20 years further demonstrates their growing value as a pain relief tool during labour. “I had the birth I’d hoped for! I used the TENS in early labour and while the contractions intensified and then birthed my baby in the pool. I love that the TENS gave me control to alter it to what felt best. It totally helped.”

WHAT ARE THE BENEFITS OF A TENS DURING LABOUR?

Using a TENS machine during labour offers several benefits for mum and baby:

DRUG-FREE:
TENS is natural and drug-free, so if your aim is to have an unmedicated labour, then you’ll certainly want to add a TENS machine to your toolkit of pain relief tools and techniques. TENS helps trigger the production of endorphins and endorphins are our body’s own natural painkillers. They’re our ‘feel-good’ hormones.
SAFE:
Clinical studies confirm TENS is completely safe for you and your baby. There are no side effects or no recovery time after using TENS.
STAY MOBILE DURING LABOUR:
A TENS machine allows you to stay mobile during labour. In fact, it’s designed for you to use the machine while moving around. The lanyard allows you to wear the controller around your neck and electrodes and cords don’t interfere with your movement. And we know that movement during labour leads to better birthing outcomes, shorter labours, fewer interventions and decreased pain.
PAIN RELIEF ON HAND AT HOME:
TENS gives you pain relief to use at home, in the car on the way to hospital and at the hospital. You may be planning a home birth so a TENS will certainly be a great tool to have at home. If you’re planning a hospital birth, you’re likely to be labouring at home for a number of hours before heading to the hospital and TENS gives you a safe form of pain relief to use at home. Even if you’re planning to use medical pain relief or use a birthing pool, remember it’s unlikely you’ll have these on hand straight away. There may be a number of hours where you’ll need to work through your contractions without having access to other forms of pain relief.
COMBINE TENS WITH OTHER FORMS OF PAIN RELIEF:
TENS can be safely combined with other forms of relief. Some women find a TENS is all they need whereas other women combine TENS with other techniques such as breathing techniques, movement, massage, hypnotherapy or aromatherapy. You can alternate using the TENS and water (but remember to remove the TENS before entering water).
IN CONTROL OF YOUR PAIN:
TENS can give you a feeling of being in control of your own pain relief which can in turn, reduce fear. Removing fear during labour can lessen your sensitivity to pain, and avoid those fear related hormone responses (such as adrenaline and cortisol) which can interfere with the production of those good hormones, like endorphins. Fear is also thought to slow down labour and inhibit the production of oxytocin, which is essential for contractions.
PAIN RELIEF BEFORE, DURING & AFTER LABOUR:
TENS can be used for back pain anywhere from 38 weeks (but you should consult your midwife prior to using it). It is also often used to help relieve after pains and back pains while learning to breastfeed.

“I could not believe the relief the TENS provided and I didn’t even use all the levels. I was fully alert during labour and even caught my own son. I cannot recommend TENS enough!”
HOW LONG SHOULD I USE THE TENS MACHINE FOR?
The best advice is to put the TENS machine on early in labour. This will allow you to adjust to its sensation and give your body time to release endorphins. Each labour and pain experience are unique, so TENS effectiveness varies widely. Some women use TENS during the first stage of labour, while others continue through the pushing stage. There is no set duration for using TENS, but use it for at least an hour to assess its effectiveness.
CAN I USE ANY TYPE OF TENS MACHINE DURING LABOUR?
No. For optimal pain management, it’s recommended to use an obstetric or labourspecific TENS unit. Unlike regular TENS machines, these are designed with dual settings, one for rest between contractions and one for a higher setting during contractions. This functionality is crucial for effectively managing the wave-like nature of contraction pain.
To ensure you get the most out of your TENS machine, it’s important to choose a high-quality obstetric model. Avoid cheaper alternatives during labour, this is not the time to cut costs. If you’re borrowing or hiring a TENS machine, make sure to schedule the delivery or pickup around three weeks before your due date. This gives you ample time to familiarise yourself with its operation and ensures you have it ready, when you need it.

HOW DO I GET THE MOST OUT OF MY TENS?

When your TENS machine arrives, test it out. Read the instructions, check the contents, and test the unit by applying sticky electrode pads to your forearm (or your partner’s) to ensure proper functionality.
Make sure you and your Birth Partner understand how the TENS works. The last thing you need is your partner reading through instructions while you need their help.
Your Birth Partner should know where to place the electrodes on your back.
If you are putting the electrodes on and off your back make sure your Birth Partner understands that looking after the sticky electrodes is their job. Keep the clear plastic sheets safe and reapply the sticky pads back onto the sheets between uses. If you wish, you can purchase an extra set of electrodes.
As soon you are realise you are in labour, apply the TENS machine. Early use increases natural endorphin production before strong contractions. Remember, endorphins are natural painkillers.
Start with the controls at the lowest setting. Gradually increase intensity as contractions strengthen. Allow yourself time to adjust to the tingling sensation.
Use the boost button at the peak of each contraction. The boost function provides intense, wave-like tingling or pulsation sensations, maximising effect during peak contractions.
Turn off the boost button once contractions end, ensuring boost benefits are felt during subsequent contractions.
Moving around during labour will help you feel more in control and can enhance the effect of TENS.
If TENS seems ineffective initially, your body may need more time, so continue its use for at least an hour before reassessment.
If stickiness diminishes, apply water drops to the gel side of the pads. Firmly attached pads maximize effectiveness.
As your labour progresses and the contractions become more intense the TENS may not be able to block all of the pain, however TENS can be safely used in conjunction with any other pain relief medication or method (other than water). If you need to, bring in your other methods of pain relief such as massage, movement, breathing techniques, aromatherapy, reflexology or gas/air.
A common approach is for women to alternate between using TENS and getting in and out of the birth pool. Remember to remove the TENS before getting into water and have your Birth Partner prepare the TENS ready for reapplication. With the TENS I happily laboured at home for a few hours. I had planned for a water birth so when I reached the hospital, the pool was filled, but my daughter had other ideas and I didn’t get time to get into the pool! I absolutely loved the TENS machine.

WHERE DO I PLACE THE ELECTRODES?

Placement of the electrode pads is important for effective pain relief. Your birth partner or midwife can assist with putting these on and it’s not difficult. Here’s how to position them correctly:

Firstly, clean and dry the skin on your back before applying the electrodes.
Carefully peel the pads from the plastic backing, avoiding pulling the lead wires. Keep hold of the plastic backing and pouch for storage for between uses. Remember you may put your TENS machine on and off, you may remove it to get into the bath or shower, so your birthing partner can put the pads back on the plastic backing for when you want it back on. They are very sticky and can be applied multiple times or if you wish, you can purchase an extra set.
Place the top two pads (connected to the left socket) approximately 4cm on either side of the spine, and 4-5cm above the belly button line (or aligned with bra strap).
Position the bottom two pads (connected to the right socket) approximately 4cm on either side of the spine, and 4-5cm below the belly button line (or on the panty line).
Everyone’s back is different, so you don’t need to get out your measuring tape, just do your best!

WHERE DO I GET A TENS UNIT FOR MY BIRTH?

Some midwives have a TENS machine you can borrow, or you can hire an obstetric TENS unit. Make sure the unit comes with clear instructions, four large electrodes, batteries, and a lanyard. Make sure it’s from a company with a good track record and good reviews. You can book a TENS at any time during your pregnancy, but if you’ve left it to the last minute, some providers offer overnight shipping.

As a midwife, I had heard and seen women using TENS and they all swore by it. I used a TENS for my homebirth and it was worth every penny – especially during transition. I couldn’t have done without it!
Words from Tessa

SAFETY GUIDELINES

Before using a TENS machine, it’s important to note some safety guidelines:

Do NOT use the TENS machine in water.
Remove the TENS before entering a bath, shower or pool.
Do NOT use a TENS machine if you have a cardiac pacemaker.
Do NOT use a TENS machine if you have epilepsy.
Check with your medical adviser before using if you suffer from a heart condition, undiagnosed pain, have any metal implants, or any doubts whatsoever.
Remember the TENS should NOT be used before the 37th week of pregnancy except under medical supervision, so if you want to use it for back pain, check with your midwife first. It is fine however to test the TENS on a low setting, for a short amount of time on your arm, or your partner’s arm.

If you have any doubts or need more information, feel free to reach out to a TENS provider or your midwife. They’re the professionals.

RESEARCH STUDIES:
Evaluating the effectiveness of TENS for maternal satisfaction in laboring parturients – Comparison with epidural analgesia: www.ncbi.nlm.nih.gov/pmc/articles/PMC8022049
Evaluation of different doses of transcutaneous nerve stimulation for pain relief during labour: a randomized controlled trial: www.pubmed.ncbi.nlm.nih.gov/30477529
Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial: www.pubmed.ncbi.nlm.nih.gov/26701166

Book your TENS for your due date now.
Natal Care Naturally
www.tenshire.co.nz

Documents / Resources

| NatalCare Labour Tens Machine [pdf] Instructions
Labour Tens Machine, Tens Machine, Machine
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