Using a TENS Unit in Labor: A Doula’s Guide to Natural Pain Relief
- Eva Monhaut-Jenkins
- May 11
- 4 min read
When my clients tell me they want tools — not just coping mantras — I often bring up one simple, powerful option: the TENS unit.
TENS (Transcutaneous Electrical Nerve Stimulation) is a small, handheld device that can provide drug-free pain relief during labor. It’s portable, non-invasive, and gives you control. And as a birth doula and childbirth educator, I love tools that put the power back in the birthing person’s hands.
Let’s break down how it works, when to use it, when to avoid it, and what the evidence actually says in this edition of "A Doula's Guide To:"
How Does a TENS Unit Work in Labor?
A TENS unit sends mild electrical impulses through electrode pads placed on your lower back and upper back. These impulses do two important things:
Stimulate the release of endorphins — your body’s natural pain-relieving hormones.
Block pain signals traveling to the brain (based on the Gate Control Theory of pain).
In early and active labor — especially with back labor — this can significantly reduce the intensity of contraction pain.
It doesn’t eliminate sensation. It doesn’t numb you.
But it can take the edge off in a way that allows you to stay grounded, mobile, and in control.
And that matters.
What Does the Evidence Say?
Research on TENS in labor shows mixed but promising results.
Studies suggest that TENS is most effective for:
Early labor
Back labor
Reducing the perception of pain intensity
Increasing maternal satisfaction and sense of control
A 2012 Cochrane review found that while TENS may not dramatically lower pain scores across all participants, many birthing people report subjective relief and would use it again in future labors.
And here’s what I tell my clients: Pain relief is not just about numbers on a scale. It’s about how supported and capable you feel.
Even when the measurable pain difference is modest, the psychological benefit of having something proactive to do can be powerful.
A Doula's Guide to When You Should Use a TENS Unit in Labor!
Timing matters.
TENS units tend to work best when started early in labor — ideally when contractions are becoming regular but still manageable.
Why?
Because the body responds better when stimulation begins before pain peaks. Waiting until labor is intense and overwhelming can make it feel less effective.
I often suggest:
Put it on at home when contractions become consistent.
Use it during early hospital labor before considering other interventions.
Turn up the intensity during contractions and lower it in between (most labor-specific units have a “boost” button for this).
It can be used while:
Walking
Swaying
Sitting on a birth ball
Leaning forward during contractions
Laboring at home or in the hospital
It’s a beautiful option for maintaining mobility.
Proper Placement of the Pads
Correct pad placement makes a big difference.
For labor, electrodes are typically placed in four spots on the back:
Two pads on either side of the spine at the level of your bra line (around T10–L1).
Two pads on either side of the spine just above the sacrum (around S2–S4).
This placement targets the nerve pathways responsible for contraction pain.
If you’re working with a doula (hi 🙋🏻♀️), we can help ensure placement is correct. Many childbirth classes — including mine — review this ahead of time so you’re not figuring it out mid-contraction.
When Should You NOT Use a TENS Unit?
TENS is generally considered safe for most healthy pregnancies, but there are important exceptions.
You should not use a TENS unit if you:
Have a pacemaker or certain heart conditions
Have epilepsy (without provider approval)
Have broken or irritated skin where pads would be placed
Have been advised against electrical stimulation by your provider
And it should never be placed:
On your abdomen
Over your uterus
On your neck or head
Always speak with your medical provider before using a TENS unit in labor to confirm it’s safe for your specific situation. And make sure you understand how to operate it properly before labor begins.
Preparation matters.
Why I Recommend It to My Doula Clients
I don’t believe in one-size-fits-all birth plans.
But I do believe in building a toolkit.
TENS is:
Non-pharmacological
Low risk
Portable
Affordable
Empowering
Compatible with other comfort measures
It can be used alongside movement, hydrotherapy, breathing techniques, massage, counterpressure, and even before choosing an epidural if that’s part of your plan.
It’s not about proving anything.
It’s about options.
And informed options create confident births.
Final Thoughts
A TENS unit isn’t magic. It won’t erase labor.
But it can be a powerful, evidence-supported tool that helps you stay present, mobile, and grounded — especially in early labor or back labor.
If you’re preparing for birth and want to understand tools like this in depth — not just what they are, but how and when to use them — that’s exactly what I teach inside my childbirth education classes and support my doula clients through.
You deserve to walk into labor knowing your options.
And knowing how to use them.
Want to kickstart your empowering birth experience?
Book a free consultation to find the right services for your needs today!
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