Madison Birth Doula | Using a TENS unit in labor

Birthing client using Elle labor TENS unit during active labor

What the heck is a TENS unit and why would I want to use it in labor?

I know right!? I didn’t know what a TENS unit actually is until a few years ago when I was bed ridden with back/leg/hip pain so bad I could barely walk. I had also never seen anyone use a TENS unit in labor before.

My amazing Chiropractor Dr. Melissa Murphy at suggested a TENS unit as part of my treatment and I was willing to give anything a try! I am so glad I did. With her adjustments and suggestions, plus adding the TENS unit in, I was even able to second shoot (photograph) a wedding — something I didn’t think I would be able to do considering the amount of pain I was in. I strapped that thing on and adjusted the settings all day based on my pain levels. It worked beautifully. That’s when I started researching the use of TENS during labor.

TENS stands for transcutaneous electrical nerve stimulation. Essentially an electrical impulse that is controlled by the person utilizing the unit is sent to each pad (4 total for the units I offer), which are placed on the laboring persons back. The labor TENS uses 4 pads, 2 placed on the lower portion of the back and 2 placed on the upper portion right at/under the bra line. There are a couple different sensation options, some people go back and forth depending on what is most comfortable for them. I have used this unit multiple times on myself for pain and really like the ability to adjust the settings/sensations.

Image of Tens Unit I provide as a doula for laboring people
Elle Labor Tens Unit and Electrode Pads
Laboring mom in triage using the ELLE labor TENS unit for pain control

The TENS unit works during labor by utilizing what is called gate control theory, which is the hypothesis that only a certain amount of stimuli can can get through to your brain at a given time. When you use the TENS unit, your brain is receiving a lot of stimuli from the unit (intensity controlled by you) which tells your brain, “HEY pay attention HERE” vs the intensity of your contractions. There is also a BOOST button that can be pressed during a contraction increasing the sensation from the unit which helps decrease your concept of pain during the contraction.

Client using labor TENS unit to help with pain during active labor

Tens use is a low risk option for pain control in pregnancy and labor, however there are some contraindications to use.

  • People with a history of seizures or epilepsy — it could potentially increase your seizure threshold
  • People who have pre-eclampsia — same reasoning as history of seizures
  • People with a pacemaker
  • Possibly during the use of internal fetal monitoring — it could potentially interfere with the heart tracing, check with your care provider first
  • If an epidural is placed — although if there is a “window” in your epidural that anesthesia can’t get rid of, ask your care providers if they feel it’s safe to use on the side you are feeling pain

My experience with TENS unit use during labor is that it works best to start when you begin to feel the early parts of labor coming on. This allows gate control theory to work optimally by teaching your brain early on which signals to pay attention to. I have found it especially helpful for that initial early back achy crampy part of labor, and during labors with a lot of back pain. Often people will use it until they hit about 6-7 cm, which is the point many clients decide to get into the tub — warm water offers a different (but can be amazing) type of pain relief.

If/when you do decide to get into the tub, the unit needs to be removed, as electricity and water (obviously) don’t work so well together. The pads can be placed back on the paper strip they came with, and replaced once you are out of the tub and your back is completely dry.

Using labor TENS with some added heat packs on the sides

One of the benefits of using TENS during labor is the ability to move around in all sorts of positions with it on. You can also add in heat and massage, although it is important not to put the heat or pressure on the actual electrodes — it doesn’t tend to feel so good.

I realized just how much the TENS unit was actually helping when I took it off to get into the tub. What a difference!

–multiple clients who have used TENS during labor

TENS during labor is very popular in Europe and Canada, but has just recently getting the attention of birthers in the United States. We are always the last to know about awesome pain relief options! I actually had to purchase my units from the UK as they do not sell the labor units in the United States unless you know specifically who to purchase from.

Although I think having certifications for 5 million different things as a doula can get pretty ridiculous, I did want to spend some extra time learning how to properly use (and when not to use) a TENS during labor. I chose Doulaversity for its online accessibility during COVID.

I currently have 2 ELLE TENS units available for client use, including one new set of sealed electrodes for each individual client use. One set of electrodes typically last an entire labor/birth and can be removed and re-placed again multiple times if needed. Clients can opt to keep a unit at home with them to put on in early labor. I also carry a unit in my birth bag as well! From my experience, however, it really is best to start as early as you feel like you need a little extra “help” during those contractions. This often happens at home prior to care providers arriving for a home birth, or going to the birth center or hospital.

Thinking about hiring a doula? Contact me through my site here or shoot me an email at I can’t wait to chat with you!

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