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Reducing pain during labor is a top priority for most moms-to-be. But given the limited options for managing pain, some pregnant people seek a more natural approach that doesn’t involve the use of medications.

And that’s why some parents-to-be are curious about the safety and effectiveness of a transcutaneous electrical nerve stimulation (TENS) unit.

A TENS machine or unit is a small device, often battery operated, that is used to manage both acute and chronic pain.

The unit has wires connected to electrodes that are placed on the skin. The electrodes deliver low voltage electrical currents to targeted body parts to control pain signals in the body.

A practitioner familiar with TENS therapy places the electrodes at or near the nerves where the pain is located. These electrical currents or impulses can create short-term or long-term relief from pain.

Experts say TENS therapy works in a couple of different ways. The first belief is that the electrical impulses affect the nervous system reducing its ability to transmit pain signals to the spinal cord and brain. But they also say that electrical impulses can stimulate the body to produce endorphins, a neurotransmitter that can help relieve pain.

“TENS unit use has been known to alleviate period, joint, back, endometriosis, arthritis, fibromyalgia, sports injuries, and postoperative pain,” says Sherry Ross, MD, OB-GYN and women’s health expert at Providence Saint John’s Health Center.

It’s essential that you do your homework when choosing a TENS unit. Ross recommends looking for one that has a reliable and good track record with a strong output intensity and with sufficient electrical impulses.

“The higher the numbers, the more helpful it will be to alleviate the pain,” Ross says.

Ideally, Ross says you’ll want to buy a pharmaceutical-grade TENS unit, going with a reputable brand. You can buy a TENS unit online through Amazon, at a CVS or Walgreens pharmacy, or through an online retailer that sells medical supplies and devices.

According to a review of the evidence, when using a TENS machine for labor pains, the electrodes are typically placed on your lower back, on specific acupuncture points, or on your head.

If you’re operating the unit yourself, you’ll regulate the intensity of the impulses during painful contractions. Most TENS units are small and battery operated, so you should be able to hold it in your hand or clip it to your clothing during contractions.

But if you’re not familiar with a TENS machine, it’s a good idea to consult with a physical therapist, midwife, or doctor who regularly uses this therapy. They’ll be able to show you how to place the electrodes on the skin as well as how to operate the machine to get the best results.

You can also hire a doula or midwife familiar with this method to operate the machine during labor. They’ll be able to place the electrodes and control the frequency of the currents coming from the TENS unit.

One of the main reasons parents-to-be consider a TENS machine is because it’s a drug-free alternative for pain management during labor.

According to Ross, the TENS unit’s ability to reduce pain sensation may be helpful in alleviating mild pain during labor. Some evidence points to the control it allows women to feel, which consequently reduces pain. It also provides a distraction from the contractions.

TENS therapy may also help reduce the dreaded low back pain that seems to strike so many women during the third trimester.

One 2012 study looked at the effectiveness of TENS in reducing low back pain during this period. Researchers divided 79 subjects into four groups: a control group and three treatment groups — one using acetaminophen, one using exercise, and the final group using TENS for pain management.

During the study period, researchers found that 57 percent of the control group experienced an increase in low back pain, while the TENS application reduced low back pain more effectively than exercise and acetaminophen.

In general, TENS therapy is considered mostly safe. That said, research involving the use of a TENS until during labor is minimal, at best.

Ross says some of the things you may notice when using the TENS unit in labor include:

TENS units are used to manage pain for a variety of conditions, including painful contractions during labor. But if this is your first time receiving treatment from a TENS machine, and you plan on using it for labor pains, Ross says to proceed with caution.

“Women who have never used the TENS unit for other pain conditions should not use it during labor for the first time,” says Ross. However, she does say the TENS unit may be useful for pain relief for women in labor if they have had success in the past using it for other painful symptoms — just don’t use it in conjunction with water immersion.

For all women, Ross says that since there are inconsistent results for women using the TENS unit, it should not be the only relied upon method for labor pains.

In other words, you may need to use other forms of pain management in combination with a TENS unit. Techniques like massage, relaxation, and breath exercises are all proven ways to help moms-to-be move through labor and childbirth with less pain.

Using a TENS unit during labor may help to manage pain. The effectiveness of the currents depends on the placement of the pads and the frequency of the currents coming from the machine.

There is minimal research regarding the effectiveness of TENS during childbirth. That’s why it’s essential that you consult with your doctor and other healthcare professionals familiar with this protocol. They can help you decide if using a TENS machine during labor is right for you.