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When it comes to natural pain relief during labour, a TENS machine is one of the most underrated tools in the birth bag. TENS stands for Transcutaneous Electrical Nerve Stimulation, and although it may sound a little clinical, it’s actually a simple, safe, and effective option that many women find incredibly helpful during the early stages of labour.
Let’s explore how it works, when to use it, what sets an obstetric TENS apart from a regular one – and why understanding how the brain processes pain makes all the difference.
A TENS machine sends small, gentle electrical impulses through the skin via electrode pads, which are usually placed on the lower back. These impulses help reduce the experience of pain in two key ways:
1. Neurological distraction and brain modulation
Older theories like the “pain gate theory” which have now been debunked through extensive research, suggested that pain signals were transmitted from the body to the spinal cord and brain and could be blocked at the spinal level. However, modern pain science has shown that pain is not simply transmitted from the body – it is an output of the brain.
Dr David Butler, an Australian physiotherapist and founder of the Neuro Orthopaedic Institute Group (NOI Group), along with his long-time collaborator Professor Lorimer Moseley, has reshaped our understanding of pain. Their research shows that the brain decides whether something is painful based on a wide range of inputs – including physical sensations, context, memory, emotions, and perceived threat.
When you use a TENS machine, you’re not blocking a pain signal – you’re changing the conversation happening in your nervous system. The electrical input provides non-threatening sensory information to the brain, helping it interpret the sensations of labour in a less alarming way. In short, it calms the nervous system and can reduce the intensity of how contractions are experienced.
2. Endorphin release
TENS also stimulates the release of endorphins – your body’s own natural pain-relieving hormones. These hormones play a key role in helping you cope with labour sensations and create a sense of wellbeing. When the machine is used early and consistently, your endorphin levels can build steadily over time, offering even greater support through the intensity of active labour.
Early labour is ideal. This is the stage when contractions are starting to become regular but are still relatively manageable. Applying the TENS machine at this stage gives your body and brain time to adjust to the stimulation and begin producing endorphins. It also supports the brain to maintain a calm, grounded state before labour intensifies.
Many women who wait until active labour to start using a TENS machine report that it feels less effective – likely because the brain is already interpreting the situation as a threat, and the nervous system is already ramped up.
It’s important to note that TENS should be removed before entering water (such as a bath, birth pool or shower) and is typically discontinued if an epidural is used.
Not all TENS machines are created equal. While general-use machines are designed for treating musculoskeletal issues like back pain, obstetric TENS machines are specifically designed for childbirth.
Here’s how they differ:
Boost button – Obstetric TENS units have a “boost” function you can press during a contraction to increase intensity, then turn off afterwards. This responsive feature is essential during labour.
Pre-set programs – designed specifically for labour rhythms, so there’s no need to manually adjust settings.
Larger pads – designed to fit comfortably and effectively on the lower back.
Ease of use – labour-friendly designs with simple controls for adjusting intensity and boosting as needed – even between contractions.
Most women can safely use a TENS machine during labour. However, it should not be used in water and should be avoided by those with a pacemaker or seizure disorders like epilepsy unless cleared by their healthcare provider.
It’s a non-invasive, medication-free option that gives women control, promotes movement, and integrates beautifully into a physiological birth plan.
Dr David Butler, founder of the NOI Group, and Professor Lorimer Moseley have transformed how we understand pain. Their book Explain Pain and ongoing education at www.noigroup.com highlight that pain is not just about what’s happening in the tissues – it’s about how the brain interprets the entire situation.
Their work explains that context, fear, beliefs, and even language can impact how pain is experienced. In labour, this means that tools like the TENS machine – which offer safe, and non-threatening input to the brain – can help reduce the brain’s perception of danger and decrease the intensity of pain experienced.
This is a powerful shift in understanding. It moves us away from simply trying to “block” pain and toward supporting the nervous system in a holistic, brain-aware way.
The TENS machine is a smart, evidence-based tool for labour that works in harmony with your body’s natural rhythms. It helps recalibrate how your brain processes sensations, supports endorphin production, and gives you a sense of control – all without interfering with your body or your baby.
Many birth workers and doulas hire out their TENS machines, making this a cost-effective option for women who may only need it for a short time. But its usefulness doesn’t end with the birth – TENS can also be incredibly helpful in the postpartum period, particularly for managing those strong after-birth pains, which can be especially intense with second or third babies or during breastfeeding.
Having it on hand during those early days can provide much-needed relief and comfort.
It’s an excellent addition to your birth toolkit – empowering you to work with your body, your brain, and your baby during one of the most important, yet intense experiences of your life.
The TENS machine that I have used for many years is the Obi-TENS by Elle TENS Australia, and the reason I recommend this one is that it is simple, sleek, lightweight, easy to use and inexpensive. They do have other models with all the bells and whistles, but I just think “keep it simple” and don’t over complicate things. But check them out for yourself and choose what best suits you and your budget.
Obi TENS | Portable Labour TENS Machine | Elle TENS Australia
If you are in Perth and you would rather hire a TENS machine, then here is a list of birth workers who hire out TENS machines and other birth equipment.
Birth Equipment Hire – Perth – Doula Training Academy
TEDxAdelaide – Lorimer Moseley – Why Things Hurt
The Drug Cabinet in the Brain
Treating Pain Using the Brain – David Butler
A ‘science’ experiment with a fake hand 😉
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki