Can A TENS Machine Reduce Labour Pain?

I was asked recently for my thoughts on using a TENS machine in labor. 

TENS stands for transcutaneous electrical nerve stimulation which means that it delivers little pulses of electrical energy that can be adjusted to a suitable frequency and strength. 

In order to manage childbirth pain well you need to understand how your body processes pain and how your mind perceives it, as well as what is happening to your body in labour.  

WHAT CAUSES THE "PAIN"

Most childbirth pain originates in the stretching of the cervix, vagina, and surrounding tissues as baby passes through. Uterine contractions work to pull the cervical muscle up out of the way so that the baby's head can then be pushed through. (Think of a turtleneck sweater being slowly stretched as you pull it over your head.) The muscles and ligaments in the pelvis are richly supplied with pressure and pain receptors in the nerves, so the stretching produces powerful sensations that may be interpreted as pain, especially if there is tension in the surrounding muscles. 

The contraction begins, tissues stretch, and the tiny pressure receptors in the nerves are stimulated, sending lightning-fast impulses along the nerves to the spinal cord. Pain receptors are stimulated as well if the surrounding muscles are tense.  
In the spinal cord these impulses must pass through a sort of gate that can stop some impulses and allow others to pass through into the brain, where they couldbe registered as pain.  

HOW DOES THE TENS MACHINE WORK?

The TENS machine slows and sometimes BLOCKS these impulses from reaching the brain where they are registered as pain.  When the TENS machine is used effectively for more than an hour, the pulses stimulate your body to release its own, natural, feel-good substances, called endorphins.  

DOES IT ACTUALLY WORK?

This is the million dollar question. Yes, the TENS machine does work but NOT in isolation. It is equally important if not more important to keep the muscles relaxed and free of tension.  The pain of labour is influenced at 3 sites

1. Where it is produced in the first place - practice deep breathing to keep muscles relaxed, counter pressure, heat, cool or water, or TENS machine.

2. At the gate in the spinal cord - light touch massage, TENS machine, breathing, movement. 

3. In the brain where the is perceived - engage all your senses - listen to music, gently encouragement from your partner, imagine your favorite place, visualise the journey your baby is taking and what is happening in your body, focus your thoughts, concentrate on your breathing, familiar smells or aromatherapy.

The TENS machine will help you in early labour but it is important to learn all the comfort measures.  In working out your own techniques for pain management, you will want to employ pain-relief measures that can control pain at all three of these sites. 

Slow, deep, relaxed but focused breathing is the MOST EFFECTIVE tool for coping with the sensations of labour and can and should be used throughout PREGNANCY and BIRTH!!!