Use of TENS and Sterile Water Papules for Labor Support

Penny Lane MSN, CNM

Objectives

At the end of the session, the learner will be able to:

  1. Describe Gate Control Theory
  2. Describe theories explaining the physiological mechanisms of pain relief using the TENS unit and sterile water papules.
  3. Discuss research findings on pain relief, safety, and women’s satisfaction with TENS and sterile water papules during labor.
  4. Demonstrate the proper application of TENS unit and administration of sterile water papules.
  5. List the parts of a TENS unit and supplies necessary for sterile water papule administration.
  6. Describe the physical sensations caused by TENS and sterile water papules.
  7. Discuss precautions of TENS and/or sterile water papule use.
  8. Discuss practice guidelines for implementation of the TENS unit and sterile water papules.

Power Point Presentation with Demonstration using TENS Units and Sterile Water Papule supplies, Video available and Pelvis/Doll for visual aide. Share Clinical Practice Guideline from Believe Midwifery Services, LLC.

Labor Pain Complexity

Review of the Gate Control Theory

Outline for Use of the TENS Unit in Labor

  1. Defining TENS
  2. Mechanisms of Pain Relief with TENS
  3. Benefits of the TENS Unit
  4. Effectiveness of TENS
  5. Cochrane Review
  6. National Institute of Health and Clinical Excellence
  7. Use of the TENS unit

Contacts for Purchasing the TENS Unit for Maternity Purposes

Mama Tens
PO Box 43537
London SW15 3XF
Tel: 0208 547 1999
0845 230 4647

/ Pulsar TENS
Spembly Medical
Newbury Road
Andover
Hampshire SP10 4DR
Tel: 01264 365 741

/ Abby TENS
1 Harefield
Grange Park Northampton
NN4 5DQ
Tel: 0845 123 2605
/ Babycare Tens
108 George Lane
South Woodford
London,
E18 1AD
Tel: 020 8532 9595

Tens-Hire
2 The Flintings, Gaddesden Row, Hemel Hempstead
Hertfordshire HP2 6JD
Tel: 01582 842638


Outline for Use of Sterile Water Papules in Labor

  1. Purpose of sterile water papules
  2. Mechanism of action
  3. Benefits of sterile water papule administration
  4. Intracutaneously vs subcutaneous administration
  5. Effectiveness of use
  6. Options for treatment

Practice and Review Clinical Practice Guidelines with Time Remaining

Bibliography

Bahasadri, S., Ahmadi-Abhari, S., Dehghani-nik, M., & Habibi, G.R. (2006). Subcutaneous sterile water injection for labour pain: a randomized controlled trial. Australian and New Zealand Journal of Obstetrics and Gynecology, 46, 102-106.

Blincoe, A.J. (2007). TENS machines and their use in managing labour pain. British Journal of Midwifery, 15(8), 516-519.

Chao, A.S., Chao, A., Wang, T.H., et al. (2007). Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labour: a randomized double-blind placebo-controlled trial. Pain, 127(3), 214-20.

Fogarty, V. (2008). Intradermal sterile water injections for the relief of low back pain in labour-a systematic review of the literature. Women and Birth, 21, 157-163.

Johnson, M. (2001). Transcutaneous Electrical Nerve Stimulation (TENS) and TENS-like devices: do they provide pain relief? Pain Reviews, 8, 121-158.

Kaplan, B., Rabinerson, D., Lurie, S., et al. (1998). Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a systematic review. Spine, 30(23), 2657-66.

Martensson, L., & Gunnar, W. (2006). Use of acupuncture and sterile water injection for labor pain: a survey in Sweden. Birth, 33(4), 289-296.

Martensson, L., McSwiggin, M., & Mercer, J.S. (2008). US midwives’ knowledge and use of sterile water injections for labor pain. Journal of Midwifery & Women’s Health, 53(2), 115-120.

McMunn, V., Bedwell, C., Neilson, J., Jones, A., Dowswell, T., & Lavender, T. (2009). A national survey of the use of TENS in labour. British Journal of Midwifery, 17(8), 492-495.

Olsen, M.F., Elden, H., Janson, E.D., et al. (2007). A comparison of high versus low intensity, high frequency transcutaneous electric nerve stimulation for painful postpartum uterine contractions. ActaObstetGynecol Scand, 86(3), 310-4.

Reynolds, J.L. (2002). Sterile water injections as a unique way to relieve back pain in labour. International Journal of Childbirth Education, 17(1), 24-25.

Rodriguez, M.A. (2005). Transcutaenous electrical nerve stimulation during birth. British Journal of Midwifery, 13(8), 522-526.