Thursday, May 27, 2010

Using the TENS machine for pain relief in Labour

Some of you might have noticed on our The Pagoda Tree facebook page, the question was asked "how do I use a TENS machine for labour?" Thats a good question! There are several variations in using a TENS. Some of you might also be scratching your head asking "what is a TENS?" TENS stands for transcutaneous electrical nerve stimulation. The point of the tens during labour is to use electrodes to stimulate the afferent nerves to bring about pain relief. Endorphins are released with the use of stimulation, much like I might use an acupuncture needle. This release of endorphins aids in labour as they are attracted to pain receptors in the body, increasing pain tolerance therefore resulting in pain relief.

There are two types of TENS machines. The conventional & the V-TENS. They differ slightly - the conventional tens uses higher frequencies. The V-TENS is biphasic. Most women will hire a conventional machine.

There must be caution taken in using TENS. It must not be used by anybody with a pacemaker and never placed over the carotid artery, over the ears, near the heart or over cuts. They must also not be used prior to 36 week gestation.

Frequency of the TENS machine ranges from 0 - 200Hz and can be applied anytime during labour, however it will work best in the earlier stages. Its important for the birthing women to be able to adjust the frequency of the TENS herself, so that she can increase it where needed.

TENS is just one way we can assist our bodies in the birthing process. Using water, especially in a bath can be a fantastic form of relief. The buoyancy and weightless of the water allows the mother to be more relaxed. In the first stages of labour it is especially important as it reduces the intensity of uterine contractions and aids the cervix in dilating. Many women will dilate very quickly once in the water! As an added bonus, water can also assist in lowering blood pressure.

If I were to use a TENS machine in labour I would also add specific ear points which are not appropriate for the unskilled person to do themselves - however anybody can apply the pads over the back, and the relief will be substantial. The following is a step by step guide.

1. Make sure to clean and dry the skin before applying the pads.
2. Remove the electrodes from their backing sheet and apply them with care, pressing firmly to make sure they have adequate and complete contact to the skin.
3. You will apply the top pair of electrodes each side of the spine between T10 & T12 (for those who don't have adequate understanding of the spine I have attached an image) & the lower two each side at S2 - S4.
4. Turn the TENS frequency right down prior to switching it on
5. Once the machine is on, the woman can adjust the frequency herself, turning it up as required.

Hopefully some will find the post useful. In the clinic I use alot of pre-labour acupuncture. The TENS machine isn't something we use regularly however for many they find it gives great relief and allows them to move through the stages of labour well.

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