Delaying an Epidural – How a TENS unit Can Help

Pregnant woman in labor with monitoring equipment.

Movement and Epidurals

When it comes to labor, many birthing people are looking for ways to manage pain while also supporting the natural progress of birth. One strategy that’s gaining more attention is delaying the use of an epidural if you are choosing one, which can help maintain freedom of movement during labor. Let’s explore why movement matters, how delaying an epidural can help, and how a TENS unit—a non-invasive pain management tool—can play a key role in this process.

Why Movement in Labor Matters

Movement during labor isn’t just about comfort—it can actually influence how labor progresses. Upright positions and the ability to walk, sway, or change positions can help the baby descend, encourage effective contractions, and may even shorten the duration of labor. According to a systematic review published in the Journal of Midwifery & Women’s Health, albeit, this study related to low-dose Combined Spinal-Epidural (CSE) or “Walking Epidurals” that are not used here in the USA for birth (that I know of!) using upright positions and movement during labor can facilitate the descent of the fetal head, preserve the urge to push, and improve uterine blood flow. These factors can contribute to a higher probability of vaginal birth and a lower risk of instrumental or cesarean delivery https://pmc.ncbi.nlm.nih.gov/articles/PMC10107776/

Delaying an Epidural

Waiting until labor is well established can help you stay mobile longer, which may support a smoother, faster birth. Some birth professionals suggest that maintaining movement in early labor can help the baby get into an optimal position and encourage labor to progress efficiently.

How a TENS Unit Can Help Delay Your Epidural

A TENS (Transcutaneous Electrical Nerve Stimulation) unit is a small, battery-operated device that delivers gentle electrical pulses through pads placed on your back. It’s non-invasive, drug-free, and can be started at home in early labor. Many people find that using a TENS unit helps them cope with contractions, making it easier to delay the request for an epidural.

Starting a TENS unit EARLY in labor can provide enough pain relief to keep you moving, upright, and engaged with your body’s natural rhythms. This can buy you valuable time—helping you reach active labor before considering an epidural, if you choose to have one at all. For more on TENS and other comfort measures, Evidence Based Birth® offers a helpful overview (Evidence Based Birth).

Tips for Using a TENS Unit in Labor

Start using the TENS unit in early labor, as soon as contractions become regular.
Place the pads on your lower back, following the device instructions.
Adjust the intensity to a comfortable level—many units have a “boost” button for stronger contractions.
Keep moving! Walk, sway, use a birth ball or change positions as needed.
If you are considering an epidural, use mobility and upright positions during the early stages of labor

In Summary

Delaying an epidural can help you stay mobile in labor, which may support your baby getting into a more optimal position and potentially a shorter birth. Using a TENS unit early in labor is a safe, non-invasive way to manage pain and keep your options open. For more evidence-based tips, check out the resources above and consider talking with your birth team about your preferences for movement and pain relief. These factors can contribute to a higher probability of vaginal birth and a lower risk of instrumental or cesarean delivery.