Positioning for Prenatal Massage - by admin@mcb on June 01 2018

Positioning for Prenatal Massage

There are two schools of thought on client positioning for prenatal massage therapy.

  1. Some therapists prefer to keep the woman in as close to fully prone and supine as possible to provide prenatal massage in the same positions as a standard massage. This is achieve with the use any number of specialty tables and support systems to achieve this purpose.
  2. Other therapists prefer to use a sidelying and modified supine position for performing massage therapy during pregnancy.

At the Institute of Somatic Therapy, we carefully considered positioning for prenatal massage. Our decision has been to teach in the  sidelying and modified supine (semi-reclining) positions. The routine we teach focuses on the back and legs while the pregnant woman is in a sidelying position, and the abdomen, arms, neck and face when she is in a modified supine position.

Why IST Prefers Sidelying Positioning for Prenatal Massage

Image from Istockphoto
Image from Istockphoto

There are several reasons why the Institute of Somatic Therapy prefers sidelying positioning for prenatal massage rather than the use of a support system that allows for a fully prone position.

Some of our reasons for preferring the side-lying position include the following:

1. Potential Strain to Uterine Ligaments: With some prenatal massage tables, it can be difficult to get a perfect, firm fit over the abdomen, so uterine ligament strain can be caused. While the woman may not notice it during the duration of the massage, she may have some discomfort afterwards.  Other systems do not provide good support for the legs, and others only allow for prone and don’t provide a way to modify the supine position to keep the weight of the uterus off the vena cava for the supine portion of the massage.

2. Ease for Client: As the pregnancy reaches the final trimester, it can be difficult for the client to get into and out of the prone position without assistance, and it can be difficult to assist an undressed client in and out of that position without compromising her privacy.

3. Cost Efficient: Most therapists already own a standard table, and can’t afford the expense of another table when it is not absolutely necessary. The cost of the sidelying and modified supine bolsters are often less than a specialty table.

4. Comfortable: A sidelying, fetal position is a very nurturing, comfortable position, one in which most people sleep, so it is very calming physically and psychologically.

5. Effective: A sidelying position places the client in a position which makes it very easy for the therapist to access her hip, IT band, piriformis, and sciatic nerve areas. These areas of the body are often in need of special focus to relieve the strain of the pregnancy. You cannot get the same access to these trouble spots in a prone position.

That being said, we realize this is a personal choice, and do not require our students to adopt this position if they have strong feelings about the prone positioning. Most of the techniques we teach are easily adapted into a prone position if that is what you and your client prefer.

Becoming Certified as a Prenatal Massage Therapist

To learn more about becoming certified as a prenatal massage therapist with Institute of Somatic Therapy, click here.

Institute of Somatic Therapy  is approved by the NCBTMB (Provider #280672-00) as a continuing education Approved Provider. Institute of Somatic Therapy is also approved by Florida (#MCE-326), and New York (#0019). Our courses are  valid for AMTA, ABMP, and most individual states.


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.

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.


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.

Prenatal Depression & Fetal Brain Development - by admin@mcb on November 30 2016

Prenatal Depression & Fetal Brain Development

An article published on www.medscape.com this week shows a negative impact of prenatal depression and postnatal depression on children’s brain development.

Researching Prenatal Depression Impact

Research was conducted under the supervision of  Catherine Lebel, PhD, University of Calgary, Alberta, Canada. She found that both prenatal depression and postpartum depression is linked to adverse cerebral cortex development in their young children.

The study looked at the depression scale readings of 52 women during all three trimesters of pregnancy and again 3 months after giving birth. Their children were given an MRI between the ages of 2.5 to 5 years old. The study revealed two types of fetal brain anomalies. Cortical thickness in two areas of the right hemisphere of the brain, and structural patterns of the white brain matter, were negatively affected by maternal depression. It was noted that most of the women did not have major depression that would have resulted in a diagnosis of depression.

“These types of changes suggest to us that the children whose mums were more depressed have a more mature pattern of brain structure. Their gray matter was thinner, and we know that with age, gray matter becomes thinner. So it looks like the kids whose mums were more depressed have this premature pattern of brain structure, almost like their brains are developing too soon,” said Dr Lebel.
“There is a lot of focus on postpartum depression, but prenatal depression exists, and it is actually quite common, and we have shown here that it is actually associated with children’s brain structures.” Dr Lebel added.

Prenatal Depression and Neurodevelopment

A related editorial was written by Amalia Londono Tobon, MD at Yale Child Study Center, New Haven, CT. She stated that current neuroscience suggests that one of the most vulnerable times for a person’s mental health is while they are in their mother’s womb. “A range of critical neurodevelopmental processes are taking place during this time… Given the complexity of this process, it is no surprise that small perturbations can lead to significant long-term consequences.” she writes.

Prenatal Massage Benefits Prenatal Depression

This adds yet another reason why massage therapy during pregnancy is so important. In addition to expected benefits like relieving muscular and skeletal aches and pains, by easing prenatal depression it also can help reduce the chance of preterm labor and improve infant brain development.

Are you ready to see your massage practice have benefits that extend to the next generation? Become a Certified Prenatal Massage Therapist through the Institute of Somatic Therapy. Click here for details and to enroll.

Texas Massage Therapy Continuing Education Requirements - by admin@mcb on October 05 2016

Texas Massage Therapy Continuing Education Requirements

Texas Massage Therapy Continuing Education Requirements

Texas massage therapy continuing education requirements are 12 hours of continuing education every two years. Courses approved by the NCBTMB are accepted by the State of Texas. Institute of Somatic Therapy is approved by the NCBTMB (Provider #280672-00), which means that our hours are valid for Texas CE requirements.

Online Continuing Education

As a Texas massage therapist, you are allowed to take all 12 hours of your continuing education online, provided that the content is cognitive. Cognitive courses are courses that teach concepts related to massage therapy, such as anatomy, physiology, etc. Kinesthetic courses are courses that teach a hands-on massage therapy technique, such as infant massage, hot stone massage, etc. Kinesthetic courses will not count toward your Texas massage therapy continuing education requirements. When taking courses specifically to fulfill your Texas massage therapy continuing education, be sure to take courses that are classified as cognitive courses (example: Prenatal Fundamentals, Aromatherapy, etc).

Texas massage therapists are allowed to take kinesthetic courses online for their own personal education and skill enhancement. The online kinesthetic courses you take will be valid for you to legally practice, even though the hours earned will not apply toward your Texas massage therapy license renewal.

Taking Both Cognitive and Kinesthetic Courses

The Institute of Somatic Therapy offers many cognitive courses to satisfy Texas massage therapy continuing education requirement. We’ve even split our most popular course topic, pregnancy massage, into two segments in order to separate the cognitive part of the course from the kinesthetic part of the course. The pregnancy massage certification consists of two 12 CE sections. Step One, Prenatal Massage Fundamentals, is cognitive, and will fulfill the 12 CEs needed to renew your Texas massage therapy license. Step Two, Prenatal Massage Techniques, is kinesthetic, so it will not count toward the 12 CEs needed to renew your license. Texas massage therapists who take both sections and complete the required homework documentation to earn the title of Certified Prenatal Massage Therapist will be completely legal to practice hands-on prenatal massage with their Texas massage therapy license.

To visit the Texas Department State Health Services website dealing with massage therapy continuing education requirements, go to http://www.dshs.texas.gov/massage/mt_ceinfo.shtm

Massage CEs: Certificate Versus Certification - by admin@mcb on June 16 2016

Massage CEs: Certificate Versus Certification

Massage CEs: Certificate

Upon completion of any type of massage therapy CE (continuing education) course, you will always receive a certificate. The certificate will show the course title, the number of hours earned, and the course provider. This certificate is what you will use to prove that you have taken continuing education that may be a requirement to renew your license or insurance. All of the courses that you take at Institute of Somatic Therapy will award a certificate of achievement available the moment you pass the online exam. By passing the exam, you automatically get your certificate for your massage CEs.

Massage CEs: Certification

But how does that differ from a certification? A certification is the awarding of an official title or status that has been earned, over and above the continuing education hours. Certification courses will include some type of documentation of internship practice sessions that have to be turned in before the title is awarded. Some of the certification titles that Institute of Somatic Therapy offers include: Certified Prenatal Massage Therapist, Certified Infant Massage Therapist/Instructor, Certified Massage Doula, and Certified Fertility Massage Therapist.

For example, when a student completes our infant massage course, as soon as they complete the online exam, they will have instant access to print out their certificate, to prove that they have earned the 16 continuing education hours that course is worth. The wording will state that “your name here” has completed “course title here” and earned a certain number hours of massage therapy CEs. But it will not award any specific titles, because none have been earned at that stage. It is just a certificate, not a certification.

Certification Requires Homework Documentation

To earn the certification title, there is also homework documentation, part of which includes having presented two infant massage classes to new parents. When that homework documentation is submitted, we send a premium gold-embossed certificate that states that “your name here” has earned the title of “Certified Infant Massage Therapist/Instructor” that is valid provided that you hold any required massage licenses in your jurisdiction.The certification document will not make reference to any number of massage therapy CEs earned, because that information was already in the first certificate you received. The certification is not about hours, it is about titles.

When you are completely done with any of our certification courses, you will have two pieces of paper in your hand: 1) a certificate that is proof of study hours being done, and 2) a certificate that states that you have earned a certification title. Think of it like going to medical school or law school. When you graduate, you earn your diploma (certificate), but you aren’t automatically a doctor or lawyer. You still have to pass the medical board or bar exam before you earn the title (certification).

Certification Courses Available

To learn more about certification courses offered by the Institute of Somatic Therapy, click on the following links:
Certified Prenatal Massage Therapist
Certified Infant Massage Therapist/Instructor
Certified Massage Doula
Certified Fertility Massage Therapist

For a follow-up article on the difference between a certification and a license, click here.

Image courtesy of www.freedigitalphoto.net: “3d Stamp Certified” by David Castillo Dominici

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.

The Role of a Doula - by admin@mcb on March 30 2016

The Role of a Doula

The Role of a Doula

I had someone ask me today about the role of a doula, and how a doula helps women have shorter, easier labors. The answer can be found in the three part definition of a doula. A doula is someone who provides physical comfort, emotional support, and information to a woman during her labor and childbirth.

The physical comfort role of a doula comes through a variety of techniques. These include massage therapy, positions and techniques to help back labor, and different laboring positions that can help bring contraction relief.

The emotional support provided by a doula is conveyed through a loving touch, a caring look, verbal encouragement, and being non-judgmental listener.

The information role of a doula will come from her doula training, from experience gained at prior births, and through resources such as Penny Simkin’s book The Birth Partner.

Long Term Satisfaction With Labor

Penny Simkin did a study a number of years back that assessed what was most important for a woman to have a long-term satisfaction with her birth experience. She had questionnaires from women she had taught in childbirth education classes back in the 1970’s. Approximately 20 years later, Penny contacted these women to interview them about birth experience. She was looking to see what long-term impacts the birthing process had for them.

While you might think what leads to long term satisfaction is a short labor, or a relatively easy labor, but that was not the case. In fact, there was no correlation between length or pain of labor with long term satisfaction. She found that the most important things were a sense of being supported and cared for, positive memories (including shared laughter) with the caregivers, and a sense of having been in control.

The factors that lead to satisfaction long term dovetail with the three aspects of doula work described above. The sense of accomplishment comes from a doula providing emotional support. The sense of control comes from the doula providing the mother with information about her options and alternatives, and helping her to adhere to her birth plan if circumstances allow. The sense of having been cared for comes from the physical support and hands-on aspect of a doula’s role.

Becoming a Doula

If you would like to help women have a satisfying labor and birth experience, get started with massage doula training today. The Institute of Somatic Therapy offers training in prenatal massage and doula support. Click here to see the courses available in this massage specialty.

NOTE: Photo courtesy of FreeDigitalPhotos.Net “Newborn” by arztsamui.