There’s little evidence supporting the use of transcutaneous electrical nerve stimulation (TENS) during labor, but does that mean it shouldn’t be recommended?

Researchers from the University of Manchester, in the UK come to a bewildering conclusion.

First, the details.

• 14 studies of 1256 women were included
  • 11 examined TENS applied to the back
  • 2 to acupuncture points
  • 1 to the cranium

And, the results.

• There was little difference in satisfaction with pain relief or in pain ratings between TENS and control groups.
  • Women receiving TENS to acupuncture points were less likely to report severe pain.
• Most women using TENS would use it again in a future labor.
• There was no evidence that TENS had any impact on management and outcomes in labor.
• There was little information on outcomes for mothers and infants.
• No adverse events were reported.
• The use of TENS at home in early labor has not been evaluated.

The bottom line?

The UK National Institute for Health and Clinical Excellence recommends that TENS should not be offered to women in labor. Probably that’s because it’s a procedure that has no impact on the process of giving birth or outcomes.

Despite this, the authors concluded, “Given the absence of adverse effects and the limited evidence base, it seems unreasonable to deny women that choice. More robust studies of effectiveness are needed.”

In the absence of sound evidence that the practice might make a positive difference, isn’t there enough to do during labor and deliver without adding to the confusion by sticking little electrodes on the skin?

3/19/10 19:47 JR