Attention Childbirth Educators – How to introduce a TENS unit to your students

As a childbirth educator and doula, I want to introduce you to a tool that many pregnant women find helpful during labor: the TENS Unit. In this blog, we will explore how it works, how to use it effectively, and whether it might be a good option for your students.

What is a TENS Unit?

A TENS (Transcutaneous Electrical Nerve Stimulation) unit is a small, battery-operated device that provides pain relief through mild electrical currents. It connects to electrode pads, or as I like to call them, “stimulating pads” (which sounds a bit less intimidating), that attach to the mother’s back. When turned on, it creates a gentle tingling or buzzing sensation that helps manage pain.

As labor progresses, the intensity of the unit can be increased in response to stronger contractions. It is essential to start using the TENS unit in early labor while contractions are still mild. This allows the mother to get accustomed to the sensation and experience the maximum benefit as labor intensifies.

The TENS unit works by reducing pain signals sent to the brain and stimulating the production of endorphins, the body’s natural painkillers. This makes it a great non-medicated option for labor.

Non-maternity and maternity TENS Units

There are numerous TENS devices available on the market, each designed to cater to different needs and preferences. Some of the most recommended units feature multiple channels for simultaneous treatment of various body areas, providing a comprehensive pain relief experience. Look for devices with positive user reviews, as they often highlight the effectiveness of the TENS unit in managing pain. Additionally, devices that come with user-friendly controls and clear instructions can enhance the overall experience.
Maternity TENS units are specifically designed for labor featuring a higher output intensity than regular TENS units, along with a boost mode that provide an extra surge of power during contractions.

Single vs. Double Channel Units

• Single-channel units control all four stimulating pads at once.
• Double-channel units allow the upper and lower pads to be adjusted independently for customized relief. Higher intensity in the lower pads is often preferred for more effective pain relief during contractions, especially in the latter stages of labor.

How Does a TENS Unit Help with Labor Pain?

TENS therapy works through two key mechanisms:

Gate Control Theory of Pain

• Your spinal cord has a “gate” that controls pain signals before they reach your brain. The TENS unit helps close this gate, reducing the perception of pain.

Endorphin Release

• Your body naturally produces endorphins to manage pain.
• The TENS unit boosts endorphin production, enhancing natural pain relief.

What Does a TENS Unit Feel Like?

Before recommending a TENS unit, I encourage you to try it yourself! By experiencing it firsthand, you’ll be able to describe it accurately to your students. Most people report a gentle tingling or buzzing sensation, which can be adjusted to a comfortable level.

Placement of Stimulating Pads (electrodes)

Correct placement of the pads is crucial for effective pain relief:

• Upper Pads: Placed just below where a bra strap would sit, about ½ to 1 inch on either side of the spine.
• Lower Pads: Positioned over the dimples in the lower back, just above the gluteal cleft

Caring for the Stimulating Pads

• Pads can be reused 10-15 times by the same person.
• Store them on their original backing sheet to maintain stickiness.
• Clean the skin with an alcohol wipe before applying to improve adhesion.

How to use a TENS unit

1. Attach the stimulating pads to the appropriate areas on the mother’s back and follow the instructions for YOUR TENS unit for attaching the lead wires to electrode pads.
2. Hand the TENS unit to the mother and have her start with a low intensity, increasing gradually to comfortable setting.
3. If using a maternity unit, use the Boost button during contractions. Turn up the intensity on the unit as needed
4. For best results, start using the TENS unit in early labor. The earlier it is started, the more effective it will be in managing pain throughout labor.

Pros and Cons of Using a TENS Unit for Labor

Advantages

✅ No known side effects for mother or baby.
✅ Can be combined with other pain relief methods.
✅ Allows movement during labor.
✅ Helps maintain focus and clarity without medication.
✅ May reduce the need for an epidural.
✅ Empowers mothers to control their pain relief.

Disadvantages

❌ Not as strong as an epidural.
❌ Not all mothers find it helpful.
❌ Cannot be used in water (birthing tub or shower).

Safety Considerations

A TENS unit should not be used:
🚫 Before 37 weeks of pregnancy.
🚫 In water (shower, bath, or birthing tub).
🚫 If the mother has a pacemaker.
🚫 If the mother has epilepsy.
🚫 On irritated or broken skin.

Informed Consent

Informed consent: Even if not a written document, the process of patients discussing the benefits and potential risks of using a TENS unit with their provider constitutes informed consent. 

Way to introduce a tens to your class:

1. When Discussing Pain Management Options:

An example of how introduce a TENS could be something like this:

“There are many ways to manage contractions, from movement and breathing to hands-on techniques and medical options. One tool that’s gaining popularity here in the U.S., but has been used for decades in the UK and Europe, is a TENS unit. Has anyone heard of it?”

This invites engagement and curiosity!

2. Demonstrating How It Works:

Once interest is piqued, briefly explain:

   •   It provides gentle electrical pulses to the back to help manage pain.

   •   It has a boost button for use during contractions.

   •   It doesn’t interfere with movement or other coping strategies.

   •   It’s drug-free and can be used at home before heading to the hospital.

If possible, let participants see or hold the unit so they feel more comfortable with it.

3. Relating It to Real-Life Use:

Many people love using a TENS unit because it allows them to stay more in control during labor. I’ve had clients say it made a huge difference in how they coped with labor. These are a few of the reviews taken from our website,: www.austinchildbirth.com

1. “I labored naturally for a very intense 5 hours and this tens unit helped me so much! Baby was sunny side up and I could feel my contractions in my back. This is such a wonderful tool for anyone in labor, so happy I had it.” Ilana Maus
2. “I am a strong advocate for the TENS unit that was rented through Jillian. I am beyond grateful that I was able to have a drug-free labor. My doctor was extremely supportive of the TENS unit and hadn’t had a patient use one during labor before me” Thank you so much for offering this to women in the US looking for safe, effective pain management during early labor. It was one of the best decisions I’ve ever made! I’m already recommending the TENS unit to all the mama-to-be’s I know.“ Emilee King
3. “I used the TENS unit at home early during labor and all the way to 7cm at the hospital. Unfortunately, it didn’t provide full pain relief through delivery but we got really far and I feel great about that.” Victoria Montemayor Castillo

Where Can You Get a TENS Unit?

Amazon, or most drug stores carry TENS units.
You can purchase or rent maternity TENS units at www.tensforlabor.com.

If you have any questions, I’m happy to help!

Final Thoughts

As childbirth educators, our goal is to provide expecting mothers with tools that empower them to have the birth experience they want. A TENS unit can be a great non-medicated option for managing pain while keeping them active and in control.

🔹 Remember: For the best results, start using the TENS unit in early labor.
🔹 Encourage mothers to try it out beforehand and discuss it with their healthcare provider.
🔹 It should not be used before 37 weeks of pregnancy.

By educating mothers about the benefits and proper use of a TENS unit, you can help them feel more confident and prepared for their labor experience. Let me know if you have any questions!