Please select the eligibility criteria that correspond to the clinical trial below.
Title: To Study and Evaluate the Effectiveness of Treatment by Percutaneous Electrical NeuroStimulation (PENS) for Post-operative Pain in Cesarean Section Patients Using Primary Relief v 2.0
Brief Summary: To study and evaluate the Effectiveness of Treatment by Percutaneous Electrical NeuroStimulation (PENS) for post-operative pain in Cesarean Section patients using First Relief


Options:
A: THIS STUDY IS BEING CONDUCTED AT A MILITARY INSTALLATION. YOU MUST HAVE MILITARY INSURANCE IN ORDER TO PARTICIPATE IN THIS STUDY.

Inclusion:

* Post-partum female (DoD beneficiaries).
* Age 18 years or older
* Pain score rating post-delivery of greater or equal to 4/10.

Exclusion:

* Absence of one or more ears
* Active cellulitis of ear
* Ear anatomy precluding identification of acupuncture landmarks
* Non-English speaking
* Use of Hearing Aids that preclude the use of ear acupuncture
* Known allergy to gold
B: Inclusion Criteria:

1. Age range between 22 - 35 years
2. Patient willing to undergo C-section surgery
3. Patient having pains after one hour of post C-Section surgery
4. Patients who is conscious and oriented for device installation after anesthetic effect
5. Patient who completed required clinical and biochemical investigations as deemed necessary by the gynecologist after post C - section surgery.
6. No previous poor obstetrical outcome
7. No experience in Han's Acupoint nerve stimulator and TENS for other reasons.
8. Term pregnancy (\> 37 weeks of gestation).
9. Understands and is willing to participate in the clinical study and can comply with study procedures.
10. Normal cognitive and communicative ability as judged by clinical assessment and ability to complete self-reported questionnaires.

Exclusion Criteria:

1. Had been diagnosed with other diseases such as preoperative presence of maternal mental, neurological disease, affecting evaluation of pains and disease condition.
2. Had combined with gestational hypertension, gestational diabetes, gestational thyroid disease.
3. Had taken analgesic drugs
4. Had used diazepam, piperazine hydrochloride or other sedative, analgesic drugs in the stage of labor.
5. Were overweight or low pregnancy weight, Body mass index (\< 18.5 or \>25 kg/m2).
6. Patients who are not agreeing to receive painless labor and not sign the informed consent form.
7. Neonatal problem requiring immediate separation from the mother for medical care or NICU admittance.
8. Severe placental abruption.
9. Hydrops (accumulation of fluid or edema in fetus body tissue and cavities) if secondary to anemia or heart failure.
10. Known twin to twin transfusion syndrome (TTS).
11. Congenital anomalies that may hamper the procedure (gastroschisis, amphalacele, spina bifida).
12. Home birth.
13. Severe mental health problem
14. Hearing impairment.
15. Legal abortion
16. Twin pregnancy
17. Instrumental birth
18. Uterine anomalies with contraindication for vaginal birth. Eg: previous opening of uterine cavity, myomectomy, congenital abnormalities.
19. Placenta anomalies.
20. Placenta praevia, suspected acreta, increta, percreta especially after previous caesarean.
21. Fetal abnormalities, growth restriction.
22. Maternal complication with surgery.
23. Subjects on any investigational drug(s) or therapeutic device(s) within 30 days preceding screening; or subject or physician anticipates use of any of these therapies by the subject during the course of the study
24. Previous participation in the Treatment Phase of this Protocol
25. Malignant disease not in remission for five years or more that has been medically or surgically treated without evidence of metastases
26. Presence of one or more medical conditions, as determined by medical history, which seriously compromises the subject's ability to complete the study, including history of poor adherence with medical treatment, unstable pain intensity or pain medications 6 weeks prior to the study, renal, hepatic, hematologic, active auto-immune or immune diseases that, in the opinion of the Investigator, would make the subject an inappropriate candidate for this study: a) One or more abnormal blood biochemistry analyte result that is ≥ 3 times that of the upper limit of the normal range
27. Known history of having Acquired Immunodeficiency Syndrome (AIDS) or with a history known to be infected with Human Immunodeficiency Virus (HIV)
28. American Heart Association (AHA) Class III and IV congestive heart failure (CHF), as defined by the following criteria: a) Class III: Symptoms with moderate exertion b) Class IV: Symptoms at rest or c) Cardiac pacemakers.
29. Subjects with a diagnosis of psychiatric disorders such as major depressive disorder, bipolar disorder, obsessive compulsive disorder, generalized anxiety, dysthymia or suicidality/suicide ideation
30. Subjects not willing to undergo treatment before discharge from the hospital.
C: Inclusion Criteria:

* Delivery by scheduled cesarean section at Brigham and Women's Hospital

Exclusion Criteria:

* Answer "yes" to the question: "Has any provider talked to you this pregnancy about medications for pain control after your c-section?"
* History of opiate abuse
* Use of chronic opiates, benzodiazepines or gabapentin
* History of chronic pain
* Cesarean hysterectomy
* Vertical skin incision
* Myomectomy at the time of cesarean section
* Non English-speaking
* Patient of the investigator performing the recruitment
D: Inclusion Criteria:

* Voluntarily
* Performed using spinal anesthesia
* ASA I (Normal healthy patients) and II (Patients with mild systemic disease) (as defined by the American Society of Anesthesiologists Physical Status Classification system)
* PARA 0000, 1, 2, 3 \[i.e. First, Second, or Third C-Section)
* At term pregnancy (\>38 weeks)
* BMI \<35
* Age between 18 - 50 years

Exclusion Criteria:

* Longitudinal surgical incision
* Placental abnormalities noted
* Time of extraction of the fetus \>10 min from cutaneous incision
* Blood loss during surgery of \>800 ml
* Any of the conditions not considered in inclusion criteria

Answer: B