Prenatal Edema - by admin@mcb on August 02 2018

Prenatal Edema

Prenatal Edema

Prenatal edema is a common condition, especially during the third trimester. In moderate levels, prenatal edema it is not a contraindication for prenatal massage. Massage therapists should use a lighter than normal touch with all fluid movement toward the heart. Some essential oils have shown to be beneficial for edema. These include geranium, lemon, rosemary, and patchouli. Several drops of one or a blend of these oils can be used in massage lotion or oil for pregnant clients with edema.

Massage therapists should be cautious with prenatal edema due to the fact that edema can be a sign of more serious conditions. It should be reported to the primary care provider for monitoring.

Severe Edema

Severe prenatal edema can be a sign of pre-eclampsia. This is a condition that may cause the woman’s body to stop sending oxygen and nutrients to the fetus. It is estimated to affect 3 – 5% of all pregnancies in the United States (source: WebMD), and up to 14% of pregnancies with multiples fetuses. Symptoms include an unusual and rapid weight gain from excess water retention (edema), the presence of protein in the urine, and hypertension (high blood pressure).

Click here to watch a short video titled “Seven Symptoms Every Pregnant Woman Should Know”  This is something massage therapists performing prenatal massage should watch for their own knowledge, and might want to use as a resource for pregnant clients.

If left unchecked, pre-eclampsia can lead to eclampsia (also known as toxemia). This more severe form of pre-eclampsia is life threatening to both the mother and baby. Symptoms of eclampsia include severe water retention, abnormal headaches, relentless back pain, sickness to stomach and/or vomiting, visual disturbances. It can lead to convulsions and coma. At higher risk for eclampsia are women with poor diets and high levels of stress in their lives, as well as previous history of high blood pressure, kidney problems, and diabetes.
It should be obvious that massage at this point is contraindicated and medical attention should be summoned at once.

Prenatal Edema and Massage

To learn more about prenatal edema, and other conditions and contraindications for prenatal massage, Institute of Somatic Therapy offers a certification course in prenatal massage. Click here for more details on becoming certified in prenatal massage.   We also offer a course titled Pathology – Edema that covers the anatomy, symptoms, and causes of edema.

Institute of Somatic Therapy is approved by the NCBTMB as a continuing education approved provider. Our courses are valid for most states, as well as liability insurance continuing education requirements.

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.

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:

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.

Maternal Migraines, Colic Linked - by admin@mcb on May 20 2017

Maternal Migraines, Colic Linked

Maternal Migraines, Colic Linked

Women with a history of migraines have a 50% greater chance of having a baby with colic, a new survey found. Fathers with a history of migraines, however, had a statistically insignificant lower chance of having a baby with colic (29%) compared to father without a history of migraines (31%). The study, conducted in February and March 2017, studied 1010 participants. Colic was defined as the baby crying for at least 3 hours per day for at least 3 days during the prior week. Fussy crying times were most common between 4:00 p.m. and midnight, with the heaviest crying between 8:00 p.m. and midnight.

Parents rated babies with colic as having increased sensitivity to loud noises and strong smells —traits often associated with migraine. Infants with a history of colic are also more likely to experience migraines in their adolescent and adult years.

Lead author Amy Gelfand, MD, director of pediatric headache at the University of California, San Francisco (UCSF), spoke at the American Headache Society (AHS) 2017 Annual Meeting. She stated that these results should be of interest to obstetricians and pediatricians. “For obstetricians, it’s worth counseling pregnant women with a history of migraine that they are more likely to have a baby with colic — and to let them know that colic is a time-limited phenomenon that isn’t their fault. For primary-care pediatricians, if you’re seeing a colicky baby with a family history of migraine, keep it in the back of your mind that these children may be coming back with headache or migraine at the age of 7 or 8 years old.”

Help for Migraines, Colic

Techniques that the parents reported as having a calming effect to the colicky infants included feeding, gentle rocking, making shushing sounds, and adding white noise.

Because increased colic is linked to maternal migraine, anything to mitigate migraines in pregnant women and mothers may be helpful. Massage therapy, both during pregnancy and postpartum, should help. Infant massage techniques can also be helpful to calm a colicky baby.

Massage Continuing Education Courses

The Institute of Somatic Therapy offers courses in prenatal massage certification and infant massage certification. Institute of Somatic Therapy is approved by the NCBTMB as a continuing education approved provider. #280672-00. Our courses are valid for most states. Click for information on becoming a Certified Prenatal Massage Therapist and/or a Certified Infant Massage Therapist/Instructor. For both certifications, see our package discount here.

Reflexology During Pregnancy - by admin@mcb on March 07 2017

Reflexology During Pregnancy

Reflexology During Pregnancy

Reflexology zones can have a far-reaching impact on the body. Reflexology during pregnancy is generally believed to be safe and effective. There is no evidence that reflexology can stimulate premature labor, and in fact is shown to be of benefit to pregnant woman.

Reflexology normalizes the functions of body parts and helps the body to regulate itself into health. Reflexology cannot, does not, and will not make the body do anything unnatural. Research has shown that women who receive regular reflexology during pregnancy experience many benefits. They are more likely to deliver closer to their due date, have shorter labors, and require less pain relief compared to women who did not receive regular reflexology during pregnancy.

When to Use Caution with Reflexology During Pregnancy

However, it is best to err on the side of caution. Reflexology during pregnancy should be considered contraindicated if there is a history of premature labor. Other precautions include severe hypertension, placenta previa or any other prenatal complication.

Jeanette Barsalini, a Certified Reflexologist, in a blog post on reflexology during pregnancy states:
There is a misconception that reflexology can increase the risk of a miscarriage during the early stages of pregnancy although the Association of Reflexologists says: “There is no evidence to even suggest that this may be the case. However, as miscarriages are more common in the first term of pregnancy, some reflexologists are not prepared to take the risk that the client may blame them should a miscarriage occur.” A miscarriage is generally a sign that there has been a problem with the baby’s development or the mother’s health and cannot be caused by a reflexology treatment.

Reflexology Continuing Education Courses

To learn more about reflexology and pregnancy massage, the Institute of Somatic Therapy offers several massage therapy continuing education courses.
Reflexology for Feet and Hands
Research – Reflexology
Prenatal Massage Certification

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

Aromatherapy During Pregnancy - by admin@mcb on January 18 2017

Aromatherapy During Pregnancy

Aromatherapy During Pregnancy

Massage therapists performing prenatal massage should use caution with essential oils, as many essential oils are considered contraindicated for pregnancy. As such, therapists should err on the side of caution in using essential oils with their pregnant clients.

Contraindications and Substitutes

When researching various oils, it is not uncommon to see some sources list a particular oil as contraindicated in pregnancy, while other sources consider that same oil safe for prenatal use. If there is any question, you should substitute known safe oils if possible. If there is no suitable substitute, use a very small amount. An alternative is to consider the use of a floral hydrosol. Hydrosols are the water byproduct of the essential oil extraction process. As such, a hydrosol will have a more gentle effect than the essential oil from the same plant.

Points to Keep in Mind When Using Aromatherapy During Pregnancy

Essential oils should be used only if the potential benefits outweigh the possible risks.

The use of aromatherapy should be omitted entirely if the pregnancy is high risk or any contraindications are present.

Your client’s heightened sense of smell and possibility of nausea are to be considered when using essential oils during pregnancy, especially in the first trimester. Allow your pregnant client to sniff the oil to make sure that she finds it pleasant before diffusing it into the room or using it on her body.

A single oil is preferable to a customized blend, especially if the massage therapist has not taken extensive aromatherapy training and learned how to properly blend oils based on both their note (intensity and duration of scent) and type (effects such as balancing or stimulating). An exception to this might be a formula pre-blended by the oil manufacturer.

In general, all oils used in pregnancy should be diluted by 50%. If you typically use 15 – 20 drops of oil per ounce of massage lotion, reduce that to 7 – 10 drops per ounce for your pregnant clients.

Continuing Education

The Institute of Somatic Therapy offers massage therapy continuing education (CE) courses on aromatherapy and prenatal massage, along with many other topics. Institute of Somatic Therapy is approved by the NCBTMB as a continuing education approved provider, #280672-00. Our course are also valid for Florida, Georgia, New York, and most states, as well as for AMTA and ABMP.

Compare Massage Doula With a Regular Doula - by admin@mcb on May 11 2016

Compare Massage Doula With a Regular Doula

How do you compare massage doula with a doula (a “regular” non-massage doula)?

A doula is a person, who is trained to provide physical comfort, emotional support, and information to a woman during the childbirthing process. A massage doula is a massage therapist who is also trained as a doula. With a background in massage therapy, a massage doula has more skills to serve her prenatal and birthing clients.

Most massage doulas are certified in prenatal massage, and possibly even infant massage. The services they can bring to a woman during her pregnancy, labor, and postpartum periods include more services than a non-massage therapist doula can bring.

Prenatal Massage

Prenatal massage therapy provides many benefits. Not only can it be a drug free method of reliving the aches and pains of pregnancy, it can also help a woman be better prepared for labor. Massage can help loosen tightness so the woman goes into labor with her body as free from tension as possible. During massage, proprioception (body awareness) is developed. This increased body awareness is helpful during contractions, to enable the woman to better relax muscles not involved in the birthing process, which helps to preserve strength and reduce unnecessary tension. Additionally, the massage doula and client develop an unspoken communication during the prenatal massages that will be beneficial in labor. The therapist will recognize abnormal muscle tension in the client, and can use that knowledge to target areas that need it the most during labor.

Doula Support

During labor, a massage doula will have much more expertise in helping to relieve muscle tension that invariably arises during contractions. Between the anatomical and muscular knowledge and experience with many bodywork modalities, a massage doula will have an advantage over a regular doula in bringing relaxation to the client. Additionally, like any doula, a massage doula is trained in topics such as positions and techniques to alleviate back labor, common complications and interventions with labor, and breathing and relaxation techniques for labor.


The massage doula will be able to perform postpartum massage designed to help the body return to its non-pregnant posture and balance. If also trained in infant massage, the massage doula will be able to teach the new parents how to massage their babies.

So the answer to our initial question, how do you compare massage doula with a regular doula?  A doula is a great idea. A massage doula is an even better one.

How to become a massage doula

Massage therapists can become certified in prenatal massage, doula support, and infant massage with online continuing education classes offered by the Institute of Somatic Therapy. Institute of Somatic Therapy (Judith Koch) is approved by the NCBTMB as a continuing education approved provider #280672-00. Our courses are also valid for Florida, Georgia, New York, AMTA, ABMP, and most states.

Illustration: “Business Concept, Businessman Compares Big Idea To Small Idea. Illustration” by aechan, courtesy of

Is prenatal massage contraindicated in the first trimester of pregnancy? - by admin@mcb on September 03 2015

Is prenatal massage contraindicated in the first trimester of pregnancy?

My friend Rachel in her first trimester, holding her one year old son.
My friend Rachel in her first trimester, holding her one year old son.

Is prenatal massage contraindicated in the first trimester of pregnancy? This is a question that certified pregnancy massage therapists encounter quite a bit.

The first trimester is the first 13 weeks of the 40 week pregnancy cycle. The 40 week (280 day) cycle count actually begins on the first day of the last menstrual cycle. With that definition, a woman is considered two weeks pregnant when she ovulates, which is the time conception actually takes place. Then it is another two weeks before her next menstrual cycle is due to begin, so if she conceived, she is considered four weeks pregnant before she even knows that she is a day late on her next period.

That means that the first third of the first trimester has elapsed before most women even knows that they are pregnant. Not all women are perfectly regular on their cycles, or if they are not trying to conceive might not even be tracking the exact dates of their periods to suspect they are pregnant for another one or two weeks or more. Often women are about halfway into their first trimester before they know that they are pregnant. As hard to imagine as this may be, there have been cases of women at full term not knowing they were pregnant until they went into labor. If the client doesn’t know they are pregnant, then the pregnancy massage therapist obviously won’t know their client is pregnant either, but technically that massage would be considered a prenatal massage since the client is pregnant.

The biggest concern about prenatal massage is the possibility of inducing a spontaneous abortion. Common sense should dictate that if something as pleasurable as massage was abortion inducing, there would be no such thing as a surgical abortion industry. Why go have surgery when you could have a massage instead? Nothing done in the course of a standard massage has ever been shown to trigger a miscarriage in the first trimester. However, if a client does know that she is pregnant and is still in the first trimester (a time for which miscarriage is most likely to occur), it is reasonable for the prenatal massage therapist to err on the side of caution, for the peace of mind of the newly pregnant woman.

In our prenatal massage certification course, we advise our students to lighten any pressure on the low back and to omit all abdominal massage during the first trimester. We also advise our students to avoid any tapotement (percussion) or shiatsu (sustained pressure to various acupressure points), at least not to the points that relate to the reproductive system. Simply performing traditional effleurage and pettrisage massage strokes over these areas would not be enough to trigger any negative response from the acupressure points.

There is no evidence based rationale for considering the first trimester of pregnancy to be a contraindication for massage therapy. The same holds true for the second and third trimester. It is advisable, however, that massage therapists who plan to work on pregnant clients on a regular basis have specialized training. Pregnancy impacts every system of the body, each of which impacts massage. By taking an advanced continuing education course in prenatal massage, massage therapists are prepared to made adjustments for each of the changes taking place in the body of their pregnant massage clients.

If you have ever considered becoming certified as a prenatal massage therapist, we hope that you will consider the courses offered at Institute of Somatic Therapy. For more information on our pregnancy massage certification courses, click here.

(Special thanks to my friend Rachel for letting us use her photo. She used this photo to announce that she is pregnant with her second baby.)