What it Means to Be a Massage Doula - by admin@mcb on May 01 2018

What it Means to Be a Massage Doula

A doula has a special relationship with an expecting mother. Having a familiarity with massage can help make that bond even stronger. ©iStockphoto.com/monkeybusinessimages
A doula has a special relationship with an expecting mother. Having a familiarity with massage can help make that bond even stronger. ©iStockphoto.com/monkeybusinessimages

A massage doula is a certified massage therapist trained to provide support during the birthing process. The three-pronged definition of a doula is one who provides: 1) emotional support, 2) physical comfort, and 3) information. The doula is there specifically to meet the mother’s needs. A birthing women benefits from a doula by receiving focused care that  primary medical providers may be unable to provide.

Doulas have a unique opportunity to serve women during childbirth. Many times the mother depends on her doula more than the doctors and nurses in the room for support and advice. This is where a background in massage therapy is beneficial for doulas. As a massage therapist you understand the benefits of relaxation and can help a mother feel calm and focused during the birth. This is especially enhanced if you have been working with her by providing prenatal massage therapy for several months leading up to labor.

Becoming a Certified Massage Doula

Our team at the Institute of Somatic Therapy has developed a certified massage doula program. This online three-part course trains massage therapists to perform prenatal massage, doula labor support, and postpartum massage. The doula portion of the course teaches many topics. It focuses on how to provide physical comfort, explain the medical benefits of a doula, and. provide pre-labor and labor coaching. You will learn a variety of laboring positions and their purposes and benefits, and how to support your client through potential labor complications.

At the Institute of Somatic Therapy we also offer a variety of additional online massage therapy courses for all of your continuing education goals. Visit us online today to learn more.

Manitoba Massage Continuing Education Approval - by admin@mcb on April 19 2018

Manitoba Massage Continuing Education Approval

Massage Therapy Association of Manitoba Approval

Attention Manitoba massage therapists: The Institute of Somatic Therapy is pleased to announce that we have received another approval for our massage continuing education. Effective April 3, 2018, Institute of Somatic Therapy has several courses approved by the Massage Therapy Association of Manitoba (MTAM) for continuing education. The MTAM is a not-for-profit association of over 1150 professional massage therapists in Manitoba. We look forward to serving Manitoba massage therapists with their continuing education needs. We are committed to providing the best online home study continuing education courses available to massage therapists.

Manitoba Massage Continuing Education Requirements

Massage Therapy Association of Manitoba members are required to complete 24 continuing education credits in a 2 year cycle due every other August 31. CE credits needed are as follows:

  • 18 CECs from Primary/Core Competency activities, and
  • up to 6 CECs from Secondary/Complementary activities.

All CECs can be from Primary/Core Competency coursers. Approved online course work is acceptable.

Manitoba Massage CE Course Approvals

The MTAM has approved the following online courses offered by the Institute of Somatic Therapy through 4/3/2020. (Click each title to go to course information page.)

Prenatal Massage Fundamentals – 12 primary/core competency credits.
Prenatal Massage Techniques – 12 primary/core competency credits.
Infant Massage – 16 primary/core competency credits.
Massage Doula Support – 21 primary/core competency credits.

Institute of Somatic Therapy plans to seek Massage Therapy Association of Manitoba approval for more of our courses in the near future. If you are a Manitoba massage therapist and are interested in more of our courses, please contact us. Let us know which courses you would like us to submit for approval next.

(MTAM Disclaimer: The approval of these courses for continuing competency credits by the MTAM Education and Competency Committee does not represent an endorsement of the course or any products or services promoted within the course.)

Additional Canadian Massage Therapy Continuing Education

Several other Canadian associations currently accept Institute of Somatic Therapy courses for continuing education. Our courses meet the criteria for College of Massage Therapists of Ontario (CMTO) and Natural Health Practitioners of Canada (NHPC). We also have course approvals pending with the College of Massage Therapists of British Columbia.

Laws can and do change, and your associations will hold you responsible for knowing the laws that apply to you. Please note that we provide this information as a courtesy, but cannot guarantee its accuracy because laws are continually subject to change.

United States Massage CE Approvals

Institute of Somatic Therapy (Judith Koch) is approved by the NCBTMB (Provider #280672-00) as a continuing education Approved Provider. Institute of Somatic Therapy is approved by Florida (#MCE-326), and New York (#0019). Our courses are also valid for AMTA, ABMP, and most individual states. Some states limit how many hours can be done online or by home study. Please refer to our State Guidelines section for specific information about your state.


Prenatal Massage Certification Frequently Asked Questions - by admin@mcb on March 20 2018

Prenatal Massage Certification Frequently Asked Questions

Institute of Somatic Therapy has been offering prenatal massage certification since 1999. (You may click all light green hyperlinks in this article to go directly to the pages they reference.)

Below are the most common questions that our potential students ask:

What will I be able to do after completing the prenatal massage certification process?

Upon completing Prenatal Massage Fundamentals (Step One) and Prenatal Massage Techniques (Step Two), you will be able to:
•  Explain how prenatal massage benefits the mother physically and emotionally
•  List and describe pregnancy related complications and their symptoms that would contraindicate massage therapy
•  Describe the physiological changes that take place in each system of a woman’s body during pregnancy, and how each of those changes dictate modifications in a standard massage routine
•  Successfully market and sell your prenatal and delivery services
•  Prepare suitable forms to use for release of liability and record-keeping
•  Perform a full body massage during all three trimesters of pregnancy, with techniques utilizing your forearms and elbows to reduce stress to your hands and thumbs. You will also be able to perform a postpartum massage.

What topics will the courses cover?

Here is just a portion of the Table of Contents from the Prenatal Massage Fundamentals and Prenatal Massage Techniques courses:

Benefits of Prenatal Massage
Research on Prenatal Massage
Understanding the Trimesters of Pregnancy
Physiological Changes in Pregnancy (covers eight anatomical systems, including  reproductive, cardiovascular, digestive, and more)
Emotional and Psychological Changes in Pregnancy
Contraindications for Prenatal Massage
Deep Vein Thrombosis
Varicose Veins
Acupuncture/Acupressure Points
Reflexology in Pregnancy
Aromatherapy in Pregnancy
Exercise in Pregnancy
Trimester Specifics
Perineal Massage
Postpartum Massage Concerns
Postpartum Depression
Marketing Your Services
Closing the Sale
Recommended Reading

What positions to you teach for prenatal massage?

The Institute of Somatic Therapy teaches a side-lying and modified supine positioning, recommended for second and third trimesters. First trimester clients can likely receive massage in the standard prone/supine positioning if they prefer, if they are able to lie flat on their stomach. We do not recommend specialty tables or equipment designed for allowing the woman to lay on her stomach after the first trimester for several reasons: Unless it is perfectly molded to her body, it will cause strain on her uterine ligaments, it is difficult to get in and out of in the final trimester, and makes no provision for a modified supine position (necessary to keep the weight of the uterus off of the vena cava).

How much is the tuition?

Prenatal Massage Fundamentals, Step One, is $129, and Prenatal Massage Techniques, Step Two, is $139. If you enroll in both at once, there is a $25 coupon (listed on the course description page) bringing the total to $243. We have many other enrollment and tuition options and packages, for example if you also want to take Infant Massage or Doula certification, or if you wish to receive hard copies of the course materials by mail. Please refer to the individual course description pages for details. We also have a “Customize Your Own Package” option that you can find HERE.

How do I enroll?

Visit the course description pages for Prenatal Massage Fundamentals (Step One) and Prenatal Massage Techniques (Step Two), (click course name to be taken to the description page) which will also have links for packages if you wish to enroll in both of these courses together or in other related courses. We also have a “Customize Your Own Package” option that you can find HERE.

How long will it take me to complete this course?

To complete the prenatal massage certification process, you must take both Steps One and Two. Each are worth 12 massage therapy continuing education credits. The number of massage continuing education hours awarded was determined by the NCBTMB. Since not everyone reads and studies at the same rate, some massage therapists report that they are faster or slower than the number of CEs awarded. The theory is that it should take the average person one clock hour for every CE earned, so a 12 hour course should take you 12 actual hours to complete. Therefore, if you work on it 6 hours a day, you’ll complete it in two days. If you work on it one hour a month, it will take you a year to complete. You can work on it at your convenience and set your own schedule. Just be sure to complete the course within one year of enrollment, or it will expire. (You can reinstate an expired course if you need more time.)

Do I have to be a licensed massage therapist to become a prenatal massage therapist?

While our courses are designed as continuing education for licensed and/or certified massage therapists, a non-licensed person may take them for their personal use. Of course, they may not legally charge for these services without a massage license if their jurisdiction requires one, as most jurisdictions do. In most jurisdictions, doulas or other prenatal healthcare providers can use the techniques within the scope of their training and authority, such as a doula using some of the prenatal massage techniques during labor and delivery. You cannot, however, hold yourself out to be a certified prenatal massage therapist without having a massage therapy certification or license.

I am currently enrolled in massage therapy school. Is it possible for me to take the prenatal certification massage package  while I am in school still?

Yes, you are welcome to begin taking the courses now. Many people do just that. The advantages to an early start are that the minute you do have your license, you’ll be certified and ready to “hit the ground running” in your chosen specialty. Just be aware that you cannot legally practice if you do not yet have any massage license that the jurisdiction where you live requires.

Will completing prenatal massage certification through you also certify me in my home state to give me a massage license to work with clients?

This common question confuses “certification” with “licensure”. Certification is evidence of education. Licensure is having a legal permit to practice a profession. Please read our blog article for an in-depth explanation on the difference between these two terms.

Are your prenatal massage certification courses valid for my state’s continuing education laws?

Institute of Somatic Therapy (Judith Koch) is approved by the NCBTMB (Provider #280672-00) as a continuing education Approved Provider. Institute of Somatic Therapy is approved by Florida (#MCE-326), and New York (#0019). Our courses are also valid for AMTA, ABMP, and most individual states. Some states limit how many hours can be done online or by home study. Please refer to our State Guidelines section for specific information about your state. Laws can and do change, and your state will hold you responsible for knowing the laws that apply to you.

Do you offer installment payments or financing?

We accept credit cards, so you can make payments to your credit card company as it fits your budget. We do not offer private financing.

Do you offer prenatal massage certification in a live classroom setting, or only online?

This course is currently only offered online. With the expense of travel and lodging for our instructor, plus her salary, plus profit and expenses for hosting schools, the tuition would be triple of what it is online. And that isn’t counting the money you would lose (lost work, potential travel expenses, etc) that would cost you on top of tuition. For more on the advantages and disadvantages for live and online courses, check out our blog post on this topic.

Do you still have questions? Feel free to ask!

We have additional information on the courses available on our website, on each course description page. Please feel free to contact the Institute of Somatic Therapy if you have other questions about our prenatal massage certification. Click this link to contact us.

Thank you for your interest in our courses.

The Institute of Somatic Therapy is approved by the NCBTMB as a continuing education Approved Provider, #280672. Our courses are valid for NCBTMB, AMTA, ABMP, and most states.

Canada: We are valid for Ontario, NHPC in Alberta, and pending approval in British Columbia and Manitoba, with more to be announced shortly.

Prenatal Massage and HELLP Syndrome - by admin@mcb on February 13 2018

Prenatal Massage and HELLP Syndrome

Prenatal Massage and HELLP Syndrome

Prenatal massage therapists need to have an understanding of complications of pregnancy that could contraindicate massage in their clients. One of the most severe conditions that may affect pregnant women is called HELLP Syndrome.

HELLP syndrome is a serious, but rare, complication of pregnancy. Chances are if a prenatal massage client has HELLP, she is too sick to come for a massage, so it is very unlikely that a prenatal massage therapist is going to encounter it during a massage session. However, if you suspect that your prenatal client has any serious complication, do not perform massage, and if necessary, call 911 or secure other help for your client.

What is HELLP Syndrome?

HELLP syndrome is extremely rare, occurring in only 2 out of 1,000 pregnancies. Approximately 20% of women who develop preeclampsia or eclampsia go on to develop HELLP Syndrome. HELLP can develop during the pregnancy or after giving birth. It is named for the following blood and liver conditions:

H–Hemolysis, a condition where red blood cells rupture, leading to a reduction in oxygen delivery throughout the body.
EL–Elevated liver enzymes, which are indicative of a problem in the liver.
LP–Low platelet count, which interferes with the ability of blood clotting.

Symptoms include:

  • Visual disturbances (blurriness)
  • Lethargy/Tiredness
  • Rapid onset of edema/water weight gain
  • Headache
  • Nausea
  • Nosebleed, or other bleeding, that persists without quickly clotting
  • Seizures
  • Abdominal pain, most often on the upper right side

HELLP syndrome can become life threatening for both the mother and the baby, so it usually leads to an emergency induction or C-Section, even if the baby must be born prematurely.

Prenatal Massage Certification

Massage therapists who wish to become certified in prenatal massage can do so through the Institute of Somatic Therapy. We offer a variety of options, including prenatal massage certification, doula certification, infant massage certification, and fertility massage certification. To see these, as well as many other massage therapy online continuing education courses, visit www.massagecredits.com.

Institute of Somatic Therapy is approved by the NCBTMB as a conatinuing education approved provider, #280672-00. Our courses are valid for NCBTMB, AMTA, ABMP, and most states.

Postpartum Depression Repercussions for Children - by admin@mcb on February 06 2018

Postpartum Depression Repercussions for Children

Postpartum Depression Repercussions for Children

The list of repercussions from postpartum depression (PPD) continues to grow, as researchers continue to discover long term effects on both the mother and her child.

A recent United Kingdom analysis of children of mothers with severe and persistent postpartum depression was published online by JAMA Psychiatry, on January 31, 2018. The article reported that the study results disclosed several long-term effects to the children. It was shown that these children

1. Had a “substantially increased risk for behavioral problems” when tested between their third and fourth birthdays,
2. received lower grades in mathematics at age 16, and
3. were more likely to suffer from depression themselves at age 18.

The results were twice as high among children whose mothers had postpartum depression than their peers whose mothers did not have postpartum depression.

The two factors that were most involved in a risk to the children was the length and severity of their mother’s depression. PPD was deemed “persistent” if the woman scored high at both her 2 and 8-month postpartum assessments. Researchers discovered that women in this category experienced “consistently higher” and “relatively stable” rates of depression for a full eleven years after childbirth.

Approximately one in nine women in the United States experience symptoms of postpartum depression, according to a study published in the February 17, 2017 issue of Morbidity and Mortality Weekly Report. As such, the problems associated with PPD are significant and lasting.

Massage Therapy Proven to Lower Depression

Numerous researchers have documented that massage therapy helps to lower depression. Research has shown that women who receive massage or other labor support (doula support) during labor have lower rates of PPD than women who do not receive doula support during labor. Even performing infant massage on their baby has been proven to have positive impact on the moods of the mother.

Becoming Certified

If you are interested in learning prenatal massage, doula, or infant massage certifications, the Institute of Somatic Therapy offers a number of certification options. To see our various options and discount packages, click here.  The Institute of Somatic Therapy is approved by the NCBTMB as a continuing education approved provider. The continuing education credits you earn from us are valid for most states, as well as ABMP and AMTA.


Pregnancy Massage Training – Is It Necessary? - by admin@mcb on November 08 2017

Pregnancy Massage Training – Is It Necessary?

Is Pregnancy Massage Training Necessary for Massage Therapists?

Have you wondered if specialized training in pregnancy massage is really necessary? After all, can’t every massage therapist simply modify the position they use for their pregnant client’s comfort, and give a standard massage?

Perhaps that would be true if the only change in a woman’s body was her inability to lay prone or supine for extended periods of time. However, pregnancy impacts every system of the body, not just her mid-section.

Physiological Changes Require Modifications for Pregnancy Massage

Clearly the most obvious changes in a pregnant body occur in the uterus. A normal uterus goes from approximately 80 grams in weight to 1200 grams by the final week of pregnancy, displacing abdominal organs and straining uterine ligaments.

The cardiovascular system increases blood output by 20 – 30 %, heart rate increases about 10 – 15%, and total blood volume increases from    30 – 50%. Pregnancy massage therapists need to modify which types of strokes they use, watch for varicose veins, and use positioning to keep the weight of the baby off the major blood vessels.

The pulmonary/respiration system requires a 30-40% increase in inhalations to meet the body’s increased demand for oxygen. Pregnancy massage therapists need to free the intercostal muscles to enable the ribs to expand fully.

The digestive system must take in extra food and digest it through displaced intestines. The renal system workload increases 35-40%. The integumentary system becomes prone to rashes, stretch marks, and pigmentation changes. The skeletal system becomes strained from the gravitational shift of the body, and joints become less stable due to a hormone the body creates during pregnancy, designed to relax ligaments for the hips to open during the birth process. The endocrine system has several hormones unique to pregnancy.

Recent research even shows that a woman’s brain chemistry changes during pregnancy, and those changes are long-term. (Citation: Nature Neuroscience volume 20 (2017), pages 287–296) Researchers in a long-term study discovered that grey matter volume changes linked to postpartum maternal attachment endured for at least 2 years post-pregnancy.

Most of these changes also require modifications in the type or focus on massage therapy strokes. Simply shifting a pregnant woman to a side-lying position will not begin to address all these needs. Pregnancy massage therapists need to tailor a massage session specifically adapted for the needs of a pregnant body.

Pregnancy Massage Certification Training

To become certified as a prenatal massage therapist, Institute of Somatic Therapy (NCBTMB approved provider 280672-00) offers an online two-part 24 CE course specifically designed to ensure that massage therapists can give the best possible therapy to their pregnant clients. To learn more, click here.

Be sure to note our package options for doula labor support, infant massage, and fertility massage.

Antidepressants Lead to Autism - by admin@mcb on August 22 2017

Antidepressants Lead to Autism

Antidepressant Drugs in Pregnancy Lead to Autism

Recent studies show that the use of antidepressant drugs during pregnancy lead to a significant increase in autism in children. The April 2017 article in the Journal of the American Medical Association was titled “Association Between Serotonergic Antidepressant Use During Pregnancy and Autism Spectrum Disorder in Children.” The study analyzed 2,837 children of mothers who, during their pregnancy, took two or more consecutive prescriptions of the most common types of antidepressant drugs.

Those children were compared to women who did not take antidepressant drugs during their pregnancies. The article reported that children whose mothers took antidepressants had a 216% increase in autism (“4.51 per 1,000 person-years compared to 2.03 per 1,000 person-years”).

This study confirmed the results of previous studies which also found a similar 200% increase of autism in children whose mothers took antidepressant drugs during pregnancy.

Antidepressant Drugs No More Effective Than Placebos

What makes this all the more troublesome is that several studies have shown that antidepressant drugs are not statically significantly more effective than a placebo for patients experiencing mild to moderate depression. (Example: http://jamanetwork.com/journals/jama/article-abstract/185157)

By taking the drugs, patients are taking significant risks for a very small chance of benefit. There are far safer alternatives, including massage therapy.

Massage Therapy Alleviates Depression

Research has repeatedly proven that massage therapy for depressed pregnant women has a positive impact, by increasing levels of dopamine and serotonin, and decreasing levels of cortisol and norepinephrine. More importantly, massage therapy during pregnancy carries none of the risks that antidepressant drugs do.

Becoming a Certified Prenatal Massage Therapist

The Institute of Somatic Therapy offers online continuing education courses in prenatal massage, as well as doula training, infant massage, and fertility massage. Institute of Somatic Therapy is approved by the NCBTMB (National Certification Board for Therapeutic Massage and Bodywork) as a continuing education approved provider. Our courses are valid for AMTA, ABMP, and most states. Please refer to the state guidelines section of our website for specific information about your state.

Birth Plans – Covering the Bases - by admin@mcb on August 07 2017

Birth Plans – Covering the Bases

Birth plans are a valuable tool for a massage doula to understand the goals of her client. Some women want to birth completely naturally, while others prefer an epidural so they can give birth with the least amount of pain possible. Women who have had a prior C-Section may just want a vaginal birth, regardless of what intervention they may need to achieve it. There is no right or wrong answer; each woman gets to determine what is right for her and her baby. The doula is in a better position to support her client if she understands the goals and mindset of that client.

Birth plans need to factor in the woman’s individual tolerance to pain, and past emotional experiences (such as sexual abuse) that might resurface during the childbearing process. It is important to help clients realize that what they plan might not be what happens during labor. Birth plans, to be most effective and complete, should consider common contingencies, and include back-up plans accordingly.

Birth Plans Don’t Always Match Reality

Labor is a “roll with the punches” pursuit if I ever saw one. Yes, it is great to have an ideal birth plan in mind, and even more wonderful if you actually get to have that type of labor. But anything can happen, and the more regimented you were mentally to stick to a rigid plan, the harder it can be to process emotionally what happened after the fact. I found in my practice that it was unrealistic to make an absolute determination in advance of whether or not you would accept various interventions.

Birth Plans Without Pain Medications

While the doula client may have every intention of having a natural labor, nature might not allow that. Maybe her water will break and contractions don’t start and artificial induction becomes necessary to lower the chance of infection to the baby. Often induced labors result in harder contractions, so going drug free becomes more challenging.

It is impossible to plan length of labor in advance, and a slow labor will lead to tiredness and stress that can make staying focused and fighting off the pain more difficult. Or maybe the mother is doing great but the baby starts to experience fetal distress and internal monitoring or even a C-Section become necessary. In all of these circumstances, failing to consider pain medications in the birth plans could result in later feelings of having been out of control or forced into something unwanted.

Birth Plans That Rely on Pain Medications

It is just as unrealistic to decide in advance that you’re going to have an epidural, in an effort to have a pain free labor. What if you progress slowly and you aren’t prepared for the pain that will happen before you’re far enough into labor that you can receive an epidural? What if you get to the point where you can have it, but you’re third in line for the anesthesiologist, and by the time he/she arrives, you’re too far along to have it? I’ve seen both of those situations occur. Failing to plan a strategy and mentally prepare for pain will make these types of situations more stressful.

The best birth plans are going to lay out the woman’s ideal birth, but they will go beyond that, and give consideration to the more common complications or interventions that may arise.

To Become a Certified Massage Doula

Massage therapists who want to become certified to attend births with their prenatal massage clients can earn the title of Certified Massage Doula through the Institute of Somatic Therapy. Institute of Somatic Therapy is approved by the NCBTMB as a containing education approved provider. Our courses are valid for AMTA, ABMP, and most state massage continuing education requirements. To learn more about becoming a certified massage doula, click here. To become a certified prenatal massage therapist, click here.


Poor Sleep a Contributing Factor to Gestational Diabetes - by admin@mcb on June 27 2017

Poor Sleep a Contributing Factor to Gestational Diabetes

Gestational Diabetes and Poor Sleep

Gestational diabetes mellitus (GDM) is a prenatal complication that can have a negative impact on both the mother and the baby. A recent study linked two different sleep behaviors (short sleep duration, and going to bed late), with an increased incidence of GDM.

The study was performed by Dr. Francesca Facco of Magee-Women’s Research Institute and Foundation at the University of Pittsburgh School of Medicine. “Few studies have objectively evaluated the duration, timing and quality of sleep in pregnancy and explored the relationship between objectively measured sleep and maternal and perinatal outcomes,” Dr. Facco and her team stated.

Their study included 782 women who were between 16 to 22 weeks into their pregnancies. The results showed that women who received less than seven hours of sleep per night (27.9% of the participants) were more than twice as likely to develop gestational diabetes as compared to those who slept longer. A separate factor in GDM was sleep midpoint, the halfway point between bedtime and rise time. Women whose sleep midpoint, regardless of duration of sleep, was later than 5 a.m. (18.9% of study participants) had an even greater odds ratio for GDM. Researchers stated that both findings were statistically significant.

The study suggests that getting to bed earlier, and sleeping more than seven hours per night, reduce the likelihood of developing GDM.

Citation: Am J Obstet Gynecol 2017.

Massage Helps Improve Sleep

The National Institutes of Health has advised that massage therapy can reduce fatigue and improve sleep.

Getting regular prenatal massage may therefore have a positive effect on lowering the risk of developing gestational diabetes.

If you wish to become certified as a prenatal massage therapist, Institute of Somatic Therapy offers certification in pregnancy massage.

Institute of Somatic Therapy is approved by the NCBTMB as a continuing education approved provider, #280672-00.


Postpartum Anxiety Relieved by Massage - by admin@mcb on June 09 2017

Postpartum Anxiety Relieved by Massage

Postpartum anxiety is one of the most common complaints in the postpartum period, and has several negative consequences. It can delay or prevent the release of oxytocin, potentially interfering with breastfeeding. Anxiety may negatively influence the emotional bond between the mother and infant, leading lead to potential psychological problems in children. Additionally, postpartum anxiety is a very strong predictor of postpartum depression. Early treatment of postpartum anxiety may help reduce postpartum depression disorder.

Research on Massage in Postpartum Anxiety

Iranian researchers conducted a controlled clinical trial to test the efficacy of massage therapy on postpartum anxiety. The study consisted of 100 primiparous (first time) mothers with normal deliveries. Women were divided into two groups – a massage group and a control group. Members of both groups were similar in age, education, and the use of medication during labor. (Citation: Iran Red Crescent Med J. 2016 Aug; 18(8): e34270. )

Massage was chosen as a treatment due to its ability to decrease levels of cortisol, adrenaline, and noradrenalin. Massage also has other beneficial physiological effects, especially muscle relaxation. Relaxation in the postpartum period decreases the activity of the sympathetic nervous system. This can prevent postpartum depression, and it can also increase effective mother-infant attachment.

Postpartum Massage

In the experimental group, slow-stroke back massage was performed for 20 minutes. The massage was described as follows:

“The mother was seated on the edge of the bed. Then, the researcher grasped the top of the mother’s shoulders with both hands and placed the thumbs of each hand just below the base of the skull, making tiny circular movements on the upper neck. In the next stage, the researcher placed the palm of one hand at the base of the skull and made a long and smooth stroke all the way down the patient’s spine to her waist. The second hand followed the first at the base of the skull and stroked down the spine as the first hand returned to the base of the skull. Next, the researcher placed her hands on either side of the mother’s neck under the mother’s ears and stroked down and over the mother’s collarbones with her thumbs just over the shoulder blades and repeated the motion several times. Then, she placed the thumb of each of her hands beside the spine, beginning with the shoulders, and moved the thumbs down the spine to the waist and repeated this movement several times. Finally, she completed the procedure by placing her palms on each side of the mother’s neck and making continuous, long, sweeping strokes down the neck, across each shoulder, and down the back near the spine and repeated the entire process several times.”

Research Results

In the control group, a researcher sat with the mother for 20 minutes but performed no massage. Twenty minutes later, and again the following morning, the mothers completed anxiety questionnaires.

Prior to the massage, both groups had similar anxiety levels as shown in questionnaires. Immediately after the massage and the next morning, there was a significant difference in the anxiety scores. After receiving the massage, the anxiety level of the experimental group was significantly reduced. Research on mothers on the first day after labor, third day after labor, and second day after birth reported similar results. The level of anxiety in the control group did not change.

As a result of this study, it is recommended that midwives, nurses, or other caregivers use massage in the early days after labor to help the mother achieve relaxation.

Learning Prenatal and Postpartum Massage

To learn more about prenatal and postpartum massage, Institute of Somatic Therapy offers a certification in prenatal massage. We also offer related courses in doula support and infant massage.