TENS and cesarean recovery

I checked out physical therapist Elizabeth Noble's Essential Exercises for the Childbearing Year last month. She wrote about using TENS for post-cesarean pain relief (p. 203):

TENS (Transcutaenous Electrical Nerve Stimulation)
This physical therapy modality works on the same principle as scratching an itch. Another message gets to your brain before the pain, traveling over nerves with faster transmission speed. Electrodes are taped above and below your incision. These electrodes are then connected to a hand-held unit with adjustable controls. You can choose the type and speed of electrical current to meet your needs. Patients who use TENS after any kind of abdominal surgery require less or no pain medication, an important advantage to breastfeeding mothers. The stimulation also reduces the incidence of paralytic ileus (intestinal distention and symptoms of obstruction). I also believe it helps to prevent the formation of a dead zone around the scar. A dead zone occurs from pain, disuse, and the mother’s reluctance to examine or palpate this area. The tissues are like dough, many women feel “cut off” from that part of the body, and nerves to the skin may indeed be injured and take many months to recover.

Another (older) book also mentioned TENS for post-cesarean recovery and pain relief. In Adrienne B. Lieberman's Easing Labor Pain, she wrote:

Transcutaneous electrical nerve stimulation (TENS), occasionally used to alleviate labor pain, also offers many benefits to the woman who is recovering from a cesarean delivery. Russsel Foley, TENS expert, comments, “Taking patients’ pain away with TENS gives them better mobility, and that’s important because the most traumatic thing to the body after an operation is immobilization. The longer a person is immobilized, the harder it is to recover.”

Using TENS can mean you’ll need fewer narcotic painkillers after your surgery. Indeed, a study published in Physical Therapy in 1986 showed that women who used TENS following cesarean birth used significantly less Demerol for pain relief. Narcotics such as Demerol, says Russel Foley, “suppress gastrointestinal motility, change respiration, and alter heart rate. If you remove the need for medication by using TENS, you can also remove the side effects of medications.”

If you use TENS for your post-cesarean recovery, the electrodes can be positioned immediately after suturing, and taped to your abdomen under the dressing. You’ll be taught to use the monitor in order to control the amount of electrical stimulation you receive. The monitor can be detached so that you can shower normally. TENS is usually used just for the first two post-cesarean days. (237)

A quick search about TENS and cesarean recovery led me to this small but promising study done last year in Iran: The Analgesic Effect of Transcutaneous Electrical Nerve Stimulation (TENS) on Caesarean Under Spinal Anaesthesia. The authors concluded that "TENS may be used as an effective, non invasive and non pharmacological approach for reducing post caesarian section pain with reduced use of analgesics. This might lead to better outcomes in pain control and facilitating development of bonding between mother and baby."

If you are planning to give birth in a hospital (or even if you aren't, in the event that you end up transferring), you might want to inquire beforehand about the availability of a TENS unit for either laboring or post-cesarean recovery. Ask the staff if they have ever used TENS for post-cesarean pain relief and if they would be willing to try it if you have a surgical birth.