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TENS again

Another topic for discussion amongst the group on Friday was the use of TENS in labour. I’ve written about this several times before, so I won’t expand on my views again, suffice to say that I agree with the Cochrane Library reviewer who stated that it was a technology that was of such little value that no further money should be spent in researching it.

I made this statement when I was asked about it by the physiotherapists in the group. They have used it a lot and are quite convinced of its effectiveness for relieving pain inlabour. They said that the Cochrane Review is quite old, published in 2000 (which it is) and that since then quite a lot of research has been done on this device in Ulster. On further enquiry, I gathered that this research was not done in pregnant women because of “ethical considerations” but that the studies completed to date suggested that the claimed efficacy of this gadget in other settings could be translated to pregnant women, at least in theory, if not in practice.

I am not so sure about all this. Somehow, the nature of labour pain, as far as I can see, is different from pain caused by a disease or injury. I am not convinced that eliminating pain in labour will be beneficial in a biological (or even an emotional or physical) sense. I am also not convinced that TENS is the answer to raising endorphin levels - and I was unable to get confirmation from these physios that this was a proven outcome of the various studies done in Ulster.

The “ethical considerations” also seem suspect to me. This is reminiscent of the obstetric anaesthetists claim that to subject epidurals to randomised controlled trials would be ethical on the grounds that some women in the trial would have to be denied access to an epidural, a move they considered was unethical and unreasonable. It is a neat way to avoid close scrutiny of a technique or procedure that may give unwelcome results.

I still maintain that TENS is a gimmick designed to make a lot of money for its manufacturers and keep women believing that they cannot give birth without technological assistance. The physios did not provide me with any hard evidence to change my mind and until I see the results of these trials in Ulster published and evaluated, I’m sticking to my views.

Posted by andrea at October 18, 2004 02:30 AM

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