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.


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.


A Day in the Life of a Massage Doula - by admin@mcb on April 25 2017

A Day in the Life of a Massage Doula

Ring…Ring. Yawn. Shake off the sleep. Ring…Ring. “My phone! Mary (pseudonym) must be having her baby. Time to kick into action as a massage doula. What time is it?” 4:15 a.m. Good, I think, I’ve gotten most of a full night’s sleep. I jump out of bed, throw some cold water on my face, brush my teeth, put on the carefully laid out clothes that have been waiting for just this moment, and off to the hospital I go. Such starts my favorite kind of day as a massage doula.

Make no mistake, getting up at 4:15 is not high on my list of things to do, but there is something calming and quieting about the wee morning hours when I know within a few hours, I will be witnessing the miracle of birth.

My interest in prenatal massage began early in my massage career. I earned my initial massage certification in 1991, and in early 1993, I became certified as a prenatal massage therapist. I immediately dove in, started working on pregnant women, and started attending labors, although at that time, I had only learned four strategies in my labor support repertoire, one of which I quickly abandoned because everyone told me to stop because it hurt.

Within in a few years, I started hearing about doulas. I had no idea what they were doing that I was not, but I thought if I only learned one new thing, it would be worth it. I got certified with Doulas of North America, and also took advanced doula training from Penny Simkin. It was after this training that I coined the term “massage doula” to refer to a certified prenatal massage therapist who is also certified as a massage doula support person.

Armed with a wide range of new techniques, I assisted over eighty births before retiring my private practice a few years ago to focus on teaching and to take on the role of Director of Education with the Institute of Somatic Therapy. With all of those births, my moms averaged under five hours of labor, only two needed C-Sections, and the vast majority birthed entirely drug free. My star client had three babies, with the total labor time from all three births only 4.5 hours (2.5 hours the first baby, 1.5 hours the second, and only 30 minutes the third).

As a doula, I could share many stories, some funny, some harrowing. I know that I will treasure my doula years forever. Not having any children of my own, I feel lucky to have been able to have so many through the experiences with my clients. I have said many times how grateful I was to have been able to watch miracles happen for a living.

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Judith Koch is the Director of Education at the Institute of Somatic Therapy, an online continuing education provider. To earn your massage doula certification, click here.

Back Labor Support from a Massage Doula - by admin@mcb on August 02 2016

Back Labor Support from a Massage Doula

Back Labor Support

One of the biggest sources of pain for a woman during childbirth is back labor. This is caused from the position of the baby putting pressure on the sacrum. The pain is due to stretching of the normally immobile sacroiliac ligaments.

Ideally, during labor, the baby is in a position where its face is towards the mother’s sacrum and its occiput is toward her pubic bone, so that the baby is facing the floor when the mother is laying on her back. However, it is not uncommon for the baby to be in an occiput posterior position (sometimes called “posterior”, “OP”, or even “sunny-side up”.) In this position, the baby is rotated so that its occiput is toward the mother’s sacrum and its head toward her pubic pone, so that the baby is facing the ceiling when the mother is laying on her back.  If the baby is in this position, the woman is very likely to experience severe pain in her low back with each contraction, called back labor.

Two Approaches to Back Labor

As a doula, there are two approaches you can take to alleviating back labor. The preferred approach is to encourage the baby to turn. The alternative is to provide counter-pressure to the sacrum to offset the pressure of the baby.

The reason that encouraging the baby to turn is preferred is also two-fold. First, it goes directly toward solving the cause of the back labor and thereby stopping the source of the pain. Secondly, it is far less work for the massage doula, as you will soon discover that applying counter pressure to the sacrum through a 60-90 second contraction every two to three minutes becomes exhausting rather quickly. If turning the baby is not an option, the father, massage doula, and any other loved one in the room can alternate the counter pressure techniques, to spread the effort among as many caregivers as possible.

There are two approaches to alleviating back labor through positioning. The first thing that you should try to do to alleviate the pain is by using a moving position that encourages the baby to turn. The Institute of Somatic Therapy Massage Doula course teaches a handful of options, any of which should cause the back labor to stop. If the baby isn’t turning, the next option can be to use one of the positions that alleviate pain. The massage doula course teaches several positions that can help alleviate the pain, even though they do not encourage the baby to turn.

If the mother is confined to the bed and unable to move (for example, she has high blood pressure or is on pitocin), as a last resort, you can use one of the techniques to relieve the pain. Those techniques are hard work for the birth assistant, and don’t do anything to prevent future pain, so are saved as a last resort or used in combination with one of the positions until the baby has turned. The massage doula course also teaches a handful of techniques that fall into this category.

Becoming a Certified Massage Doula

To become a certified massage doula through the Institute of Somatic Therapy, you will complete a three step program. Click here for more on each step and to get started today.

Benefits of a Doula - by admin@mcb on July 12 2016

Benefits of a Doula

Benefits of a Doula During Labor

The benefits of a doula are significant, and they are well established by scientific medical research. The most publicized statistics tend to deal with the labor itself – reduction of cesarean section by 50%, shorten length of labor by 25%, reduction of oxytocin (pitocin) use by 40%, reduction in pain medication by 30%, and reductions in epidurals by 60%. (Source: Marshall H. Klaus, M.D.; John H. Kennell, M.D.; Phyllis H. Klaus, M.Ed., C.S.W.)

Benefits of a Doula On Marriage and Relationships

But one lesser known benefit of a doula is the impact it can have on the relationship between the birthing mother and her partner.  W.L. Wolman wrote a Master’s thesis for the University of Witwatersrand (Johannesburg, South Africa) in 1991, titled Social Support During Childbirth: Psychological and Physiological Outcomes.  In this study, Wolman reported on women (some of whom had doulas, and some who did not) who were asked to rate the satisfaction with their partners both before the pregnancy, during the pregnancy, and after the baby was born.

Among women who did not have a doula, 63% reported satisfaction before the pregnancy, compared to 65% for the women who did have a doula. Both groups reported very similar numbers.

During the pregnancy, it dropped, but both were still very similar. The non-doula group reported a 48% satisfaction with their partner during the pregnancy, compared to 49% for the women who did have a doula.

But there was a highly significant difference in how both groups of women rated their satisfaction with their partners after the baby was born. The non-doula group stayed near the lower satisfaction rate of their pregnancy – 49%. The doula group, however, reported an astonishing 85% satisfaction rate with their partner after their births. Not only did they recover the drop that occurred during the pregnancy, but also gained an additional 20% over the pre-pregnancy rating.

When asked if the relationship was better after the birth, only 30% of the women in the non-doula group felt that it was, while 71% of the women in the doula group felt that their marriage/relationship was better after the birth.

While the study did not specify any reasoning for this, it has been suggested that some of the reasons might be that the women felt appreciative for the extra support. By hiring a doula, the partner demonstrated concern and love, as well as an acknowledgement of the enormity of the woman’s efforts during the pregnancy and labor. They may also have been less likely to place blame on the partner for any negative outcomes knowing that everything possible was done to make the birth as easy as possible.

Becoming a Massage Doula

If you are a massage therapist who wants to become trained as a doula, the Institute of Somatic Therapy offers a doula certification program, available here.

Finding a Massage Doula

If you are looking for a doula to support you or your partner during childbirth, the Institute of Somatic Therapy has a database of graduates where you can search for prenatal massage therapists, massage doulas, and infant massage instructors, available here.

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 freedigitialphoto.net.

Massage Doula Impact on Traumatic Birth - by admin@mcb on December 01 2015

Massage Doula Impact on Traumatic Birth

Approximately 1 woman out of every 4 considers that her labor and delivery experience was a traumatic birth. With 4 million births in the US per year, that is one million women per year who experience traumatic births. (Source: Prevention and Treatment of Traumatic Childbirth (PATTCh.org) By having a massage doula with her during birth, a pregnant woman can increase her odds of not being part of these statistics.

Feelings of a traumatic birth tend to occur if the mother feels that she or her baby were in some type of danger during the labor process. These feelings can also occur if the woman feels that she was out of control and helpless during the labor. Having a massage doula helps to reduce both of those, due to the loving presence of a birth support provider.

Post traumatic stress disorder (PTSD) is not outside the range of possibility if the traumatic birth experience is not dealt with. As a massage doula, you should know the signs of birth PTSD. The signs are: nightmares, dwelling on the birth, avoidance behaviors, and reluctance to talk about the birth. Other signs are avoiding postpartum obstetric appointments, blame or negative feelings toward people who were part of the birth, anger, and sleep disorders. If these signs are present for more than a month after the birth, the mother likely has some degree of birth PTSD.

During labor support, if a massage doula believes that her client’s birth expectations are not being met, she needs to try to focus her client on getting through the moment and help her deal with the trauma as it happens, to help prevent long term negative consequences. After the birth, encourage her to get plenty of sleep, exercise, use some type of relaxation method (massage, yoga, etc), or seek counseling. You can also refer them to http://pattch.org/resource-guide.

To become trained as a massage doula, click here: Massage Doula Certification

To find a certified massage doula in your area, click here: www.massagedoula.com