Hello, my name is Jackie and I am one of the Women’s Health physiotherapists. This is a short instructional video on how to use a TENS machine for pain relief in labour. Along with the leaflet TENS – use in labour which there is also a link to here, it should give you all the information you need to safely use TENS in your labour.
To hire a TENS unit from the hospital you must print out the hire form also linked in this section and sign it to confirm you have watched this video and read the leaflet. Fill in your name, address and telephone number and bring the form in to the Rehabilitation Centre at The James Cook University Hospital Monday to Friday between 9am and 3pm. This is easiest to access via the South Entrance. You will also need to bring £30 cash to hire the machine. The actual cost is £20, but you get a £10 deposit back when you return the unit. Please wait until you are 37 weeks pregnant before coming in to collect a machine so that we don’t run out of stock.
If you have any problems printing a form, please contact us on 01642 850850 extension 53741 and we can post one out to you.
TENS stands for Transcutaneous (which means through the skin) Electrical Nerve Stimulation. It’s a battery operated, electrical unit, that gives a tingling sensation via electrodes by stimulating the nerves through the skin, to help give pain relief.
The TENS machine used in labour has a base unit with various settings which are pre programmed and intensity dials as well as an attached booster button. It operates using a 9 volt square battery which is supplied. There are 2 wires that attach to the unit each corresponding to the 2 intensity dials. Each wire splits into 2 and then in turn each attach to a pair of sticky electrode pads (a bit like a large, thick sticky plaster). When used in labour, these pads are placed on the mother’s back.
It works to relieve pain in 2 ways. One is that it stimulates your body to produce more endorphins, which are the body’s natural painkilling hormones. Secondly, it helps the brain to ‘tune out’ some of the painful signals it receives. A bit like when you bang your arm and instinctively rub it to relieve the pain – you are giving a different signal to your brain which helps to reduce the effect of the painful signals. An electrical distraction if you like.
TENS can be used with all other forms of pain relief in labour – if you have an epidural, you can remove the lower pads during insertion of the epidural and then remove the upper pads once the epidural is working.
It is completely safe to use. It’s not addictive, is non-invasive and has no known side effects to mother or baby. However, it is an electrical unit so DO NOT use it in water. Remove during a bath and then re-apply the sticky pads when the skin is dry – pop the pads on the clear plastic sheet they came on. The pads keep their stickiness and can be re-applied a number of times. There are very few reasons you would not be able to use a TENS machine but DO NOT use if you have Epilepsy, have a cardiac pacemaker, have broken skin or numb areas on your back, have been diagnosed with cancer and also avoid driving while using it.
- Before applying the TENS, make sure your back is dry and oil-free
- Place the supplied 9 volt square battery into the machine
- Connect the white ends of the 4 electrode pads to the black and red ends of the leads. Each pair of electrodes should be attached to 1 lead (with one black, one red end). It’s irrelevant whether it’s red or black so don’t worry.
- Make sure that both intensity dials are switched off and then connect the 2 leads to the 2 terminals at the side of the machine.
- Then apply the sticky electrode pads to the back (the positioning of the pads is important to target the appropriate nerve roots, but the pads are quite large so it gives you some eeway)
- It’s a good idea for birthing partners to watch this video and make sure they are happy they know where to place the electrodes for you.
One pair of electrodes is placed with their top edge around bra level and about 2-3 cm/1 inch either side of the spine. The other pair of electrodes is placed at the level of the sacral dimples (at the base of your spine), again 2-3cm/1 inch either side of the spine.
It doesn’t matter whether the white leads come out of the side or ends of the pads as long as the pads are placed with the short ends at the top and bottom.
Now the machine is set up and ready to use, it is important the only the woman in labour herself operates the machine, as only she can feel the electrical stimulation.Check the booster button is in the raised position (not pressed down) to begin with for
a low frequency, pulsating setting (the machine has pre-set frequencies so you don’t
need to adjust anything)
- Check both channels are working by slowly turning one dial on until a mild tingling sensation is felt, then do the same for the other dial.
- Once you know both channels are working, switch on both dials in turn and slowly increase the intensity until a strong tingling sensation is clearly felt through both sets of pads and then turn the dials back down a little to a comfortable level.
- When you feel a contraction start, press the booster button down to change to a higher frequency, continuous setting.
- When the contraction has stopped, press the button again to the raised position which switches the ‘boost’ function off and returns to the low frequency, pulsating setting.
- As the brain becomes used to the sensation and as pain levels increase over time, the
- intensity dials will need to be turned up to increase the tingling sensation felt.
- When the TENS is no longer needed, turn both intensity dials off before removing the
- Dispose of the pads only, but keep the leads and return the TENS unit in its case to the Rehabilitation Centre to claim your deposit (preferably within 2 weeks after your delivery date).
I hope you have found this video useful. If you would like to hire a TENS machine from the hospital, please read the TENS leaflet on the link here and print out the TENS hire form also linked in here.
All the best in your labour and beyond.