TENS Unit for Labor: How It Works & Who Should Use It

Birthing client using Elle labor TENS unit during active labor

TENS Unit for Labor: What It Is and How It Helps With Pain

If you’re looking for drug-free ways to manage contractions, a TENS unit for labor is one of the most overlooked options in the U.S. As a birth doula in Madison, WI, I bring labor TENS units to my clients’ births. Here’s what a TENS machine does, when to start using it, and who should skip it.

What is a TENS unit?

TENS stands for transcutaneous electrical nerve stimulation. A small, handheld device sends gentle electrical pulses through electrode pads placed on your skin. You control the intensity yourself.

I first learned about TENS when I was dealing with back, leg, and hip pain so intense I could barely walk. My chiropractor, Dr. Melissa Murphy of Discover Family Chiropractic, suggested adding a TENS unit to my treatment plan. Between her adjustments and the TENS, I was able to second shoot a wedding, adjusting the settings all day based on my pain. That experience is what led me to research TENS for labor.

How does a TENS unit work during labor?

A labor TENS unit uses four pads: two on the lower back and two on the upper back, right at or under the bra line. You choose from a few sensation settings and can switch between them depending on what feels best.

The idea behind it is gate control theory, the hypothesis that your brain can only process so many sensations at once. The steady tingling from the TENS gives your brain something else to focus on, which can make contractions feel less intense. There is also a boost button you can press during a contraction to turn the sensation up right when you need it.

It’s worth knowing that research on TENS for labor pain is mixed. Studies haven’t consistently shown that it lowers pain scores, though it appears safe and many people say it helps them cope. In my experience supporting clients, it’s most useful for early labor and back labor. It’s a coping tool that works well alongside other comfort measures, not a replacement for an epidural.

When should you start using a TENS unit in labor?

Start early. I recommend putting it on when you first feel labor coming on, often at home, so your brain gets used to the sensation before contractions get intense. It’s especially helpful for:

The achy, crampy feeling of early labor
Labors with a lot of back pain
Laboring at home, in triage, or while waiting for your birth team to arrive

Many clients use it until about 6-7 cm dilation, which is often when they choose to get in the tub.

Birth Doula in Madison WI — Laboring mother on birth ball using a labor tens to help with pain during contractions

Can you use a TENS unit in the tub?

No. Electricity and water don’t mix, so the unit has to come off before you get in. Place the pads back on their plastic backing, and reapply them once you’re out and your back is completely dry. Several clients have told me they didn’t realize how much the TENS was helping until they took it off, so be ready for that.

Moving, heat, and massage with a TENS unit

One of the best things about labor TENS is that you can move freely. Walk, sway, change positions, and add heat packs or massage. Just keep heat and pressure off the electrodes themselves.

Who should not use a TENS unit in labor?

TENS is considered low risk, but it isn’t right for everyone. Avoid it or talk to your care provider first if you have:

A history of seizures or epilepsy
Preeclampsia
A pacemaker
Internal fetal monitoring (it may interfere with the heart tracing, so check with your provider)
An epidural (if you have a spot the epidural isn’t covering, ask your provider whether it’s safe to use on that side)

Always check with your doctor or midwife before using a TENS unit.

Is TENS popular for labor outside the U.S.?

Yes. TENS is widely used in labor in the UK, Europe, and Canada, and it’s only recently gaining attention in the United States. Labor-specific units aren’t sold here through typical retailers, so I ordered mine from the UK.

Labor TENS available for all of my birth doula clients

I have two ELLE TENS units available for clients. Each client gets a new sealed set of electrodes, which typically lasts an entire labor and can be removed and reapplied as needed. You can keep a unit at home to start in early labor, and I carry and extra one in my birth bag too.

Image of Tens Unit I provide as a doula for laboring people — Elle Tens Unit and Electrode Pads

Frequently asked questions

Does a TENS unit hurt?
It feels like a tingling or buzzing sensation, and you control how strong it is. The units I carry have two different types of buzzing sensations for in between contractions and a button you push during a contraction that gives one smooth wave like sensation.

Can I use a TENS unit at a hospital, birth center, or home birth?
Yes, in most cases. It’s a good idea to mention it to your provider ahead of time.

Where do TENS pads go for labor?
Two on the lower back and two on the upper back, at or under the bra line.

Is a TENS unit safe during pregnancy?
Labor TENS units are designed for use in labor, and are generally considered low risk. Talk to your provider before using one earlier in pregnancy.

Interested in working with a Madison birth doula?

If you’d like labor support, including access to a TENS unit, contact me here or email hello@birthside.com. I’d love to chat.

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