National survey of the use of TENS in labour

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive method of pain relief, regularly used by women In labour. The National Institute for Health and Clinical Excellence (NICE) intrapartum care guidelines do not recommend its use on grounds of ineffectiveness to reduce pain. However, the recent Cochrane review challenges this guidance, as previous studies have limited capability to exclude an effect, and there is evidence that some women choose TENS as their preferred method of pain relief. We aimed to explore whether the NICE guidelines have impacted on health professionals' support for the use of TENS, and to determine support for a possible clinical trial of TENS. We therefore conducted a national survey of all maternity units in England; responses were received from 139 (76%) of the units. The findings demonstrate overwhelming support for TENS use. Furthermore, the survey identified a willingness among midwives to conduct a multi-centre trial of TENS versus usual care. We conclude that the combination of a dearth of robust evidence together with midwives' beliefs that TENS should be an available pain relieving option, confirms the need for a randomized controlled trial.