Online Course & Online Test

The online test for this course contains  80  multiple choice questions.

Massage Therapy CEs | Prenatal/Doula/Infant Courses

Certified Massage Doula

PRE-REQUISITE:  Prenatal Massage Specialist (steps one and two) through the Institute of Somatic Therapy. (You may take just the doula portion if you have earned prenatal massage certification elsewhere, however, you are not able to earn the doula specialist title through us if you have not completed the prenatal training with us.) Please see a detailed explanation for this policy in the FAQ section below.

Tuition  for this Doula Portion: US $229   

Course Format: This course is offered online, available instantly at your convenience. We are not currently offering live seminars.

To enroll: Simply click the green "buy now" button. You will see the course in your shopping cart, with the option to continue shopping (if you want to enroll in more than one course) or checkout. Once you click checkout, it will take you through the process of creating a new account if you do not have one, or logging into an existing account if we find an account already associated with your email address. You do not need to have an existing account before you add a course to your shopping cart.

If enrolling in the prenatal and doula courses together, be sure to check our  Package Special Prices.  In our customized packages, you can receive a discount of up to 15% (depending on tuition value) when you enroll in any three or more of our courses at the same time. (All amounts are in US Dollars). The prenatal specialist package counts as two courses, since it consists of Prenatal Massage Fundamentals (Step One) and Prenatal Massage Techniques (Step Two). Please note that our package specials are non-changeable/non-refundable. You have one year from enrollment to complete the courses.    

Instructor: Judith Koch Stapleton

Course Description: If you wish to become a Massage Doula Specialist, you must already be a prenatal massage specialist therapist, by having taken our Prenatal Massage Fundamentals and Prenatal Massage Techniques courses. You will then take the Massage Doula course (worth 21 CEs). This portion of the course does not teach massage technique, since you will already have learned all the techniques that may be referenced in the Massage Doula training.  

In this course you will study how to:  

  1. Provide physical comfort, information, and emotional support during childbirth
  2. Describe and explain the medically proven benefits of continuous labor support services (also known as doula services)
  3. Describe and understand the physical processes that make up the three stages of labor
  4. Study common interventions in labor
  5. Study some of the possible complications that can arise in labor
  6. Suggest a number of various positions for laboring that decrease discomfort and back labor, and promote more effective pushing

Table of Contents:   

  1. Labor Support Providers Terminology and Roles           
  2. Benefits of Labor Support                     
  3. Long Term Perceptions of Childbirth               
  4. Comparison of Father to Professional Support Provider    
  5. Stimulating Labor Naturally                     
  6. Breech Presentation                          
  7. Special Needs in Labor                         
  8. VBAC information                             
  9. Stages of Labor                             
  10. Terminology You’ll Hear During Labor                  
  11. At the Hospital                            
  12. Common Interventions  in Labor               
  13. Possible Complications in Labor                  
  14. Birth Stories                                 
  15. Back Labor                                   
  16. Stage Two – Pushing                        
  17. Equipment List                             
  18. Pricing Your Services                        
  19. Miscellaneous Recommendations              
  20. Recommended Reading                      
  21. Sample Forms              

Required Course Activities: You read study the course materials, then complete your online exam to earn your  CEUs. This can be done immediately upon enrolling in the course, to earn your CEUs right away. To earn the title of "Massage Doula Specialist", you must read The Birth Partner by Penny Simkin (you must provide your own copy of the book), and attend three births as a doula intern. You will perform a self evaluation on each birth (sample questions: Looking back at your role in this birth, what was the best part of the experience? How you can build on that in future births? What was the biggest challenge you faced? What can you do to mitigate this challenge so it is less a problem in the future? What comfort measures did you provide? Based on this experience, what are THREE things you can do better next time?)  Additionally, your clients must be willing to sign an evaluation and release allowing you to provide the birth record that you completed (we provide the birth record form, which tracks labor progress, and complications or interventions), along with their name, address, and phone or email address so that we can verify the internship sessions. 

Additional Required Reading: There is one required reading book which is not included in your tuition or in the course materials we provide. You are welcome to either purchase the book new or used, or borrow it from a friend or library. The title is The Birth Partner by Penny Simkin. It is easily available with online bookstores.  

For your CEs, simply print the online certificate associated with the online test. No further homework or fees are required to earn your CEs. However, if you also wish to earn the OPTIONAL title of Massage Doula Specialist, you must complete the online homework documentation along with a processing fee of US$35.00. Refer to the final course chapter instructions for details when you are ready to apply. Neither the NCBTMB nor any state massage therapy boards make a determination on the awarding of the title of Massage Doula Specialist.  

CERTIFICATION UPDATE posted November 17, 2022. Revised June, 2023: We have been notified that the NCBTMB is no longer allowing approved CE providers to award certification titles without having received third party accreditation, which is not available to CE providers who are not affiliated with a 500 or more hour massage school. As a CE provider, and not an initial massage school, we do not fit in this category, and will have to modify the title awarded upon completion of the optional internship. We had been using the title "Certified Massage Doula", but to stay in compliance with the board rules, the new title will be "Massage Doula Specialist". We are working with the board and our website development team to implement the changes in a timely fashion. Students who have already enrolled or enroll within the next few weeks will have a short grace period (exact date unknown at this time) to still earn the certification title. All enrollees, regardless of enrollment date, understand and agree that the title they earn will depend on the date that they submit the internship forms.

COVID: For more information on COVID-19 as it relates to doula practices, please see this article by the World Health Organization. If link does not work, copy and paste the following into your browser: It states in part: “In the ‘new normal’ of COVID-19, WHO strongly recommends that the emotional, practical and health benefits of having a chosen labour companion are respected and accommodated. The pandemic must not disrupt every woman’s right to high-quality, respectful maternity care.”     


CE Broker Reporting:  Institute of Somatic Therapy will automatically report your hours to CE Broker in applicable states ONLY IF you have provided your license number in your online account with us. You can verify your license information by logging on to our website, and reviewing your account information. If your license is not shown there, please select “edit” to include it. These hours will be reported under the "General" category (not live) if your state recognizes doula training as a valid category of continuing education.


Frequently asked questions (FAQs): 


I have earned prenatal massage certification elsewhere. Why must I repeat that through you in order to become a massage doula through the Institute of Somatic Therapy? 


This program (the prenatal and doula training) was originally designed as one single course, but because we had a lot of students who wanted prenatal trianing without doula training, we divided the information as best we could. This works great for people who only want prenatal, or want to upgrade to doula after taking our prenatal, as they get everything we offer. The prenatal is the foundation that leads to the doula. That is the reason why we require our prenatal training as a pre-requisite to also award someone our doula specialty title.

The trouble is that we often get people, such as yourself, who only want to take our doula training, but not the prenatal, so they miss all of the foundation that we carefully laid. We have seen so many prenatal courses that are not a fraction of the foundation that ours offer. I once encountered one who had the woman butt naked on her hands and knees on the table. I was beyond appalled. Many are nothing more than a massage in side-lying position that don’t get into any of the things like the physiological changes of pregnancy and how they impact every system of the body or a thorough study of prenatal contraindications. As a result, we can’t really feel confident that people who took a potentially inferior prenatal course as their foundation to have the same level of success in the labor room as students who took our program. As such, we don’t feel comfortable awarding a speciality title in that situation.

This is why we offer the doula portion alone to people who want to move forward in that direction on their own, but we will not give them the blessing of our specialty title without ensuring that they are fully trained to our standards and specifications.

In reality, even if you have earned prenatal certification elsewhere, and even if it was an excellent course, to take our complete program of prenatal and doula, with the discount you can get with the package (15% off both) compared to the doula by itself with no discount that applies, the dollar difference is minimal - at most the cost of 2-3 massages. For that very small investment, you would earn 24 extra continuing education credits, get at worst a great fresher and at best a lot of new information and ideas, and the ability to earn the doula speciality title. We believe it is well worth it, and hope you will agree.  

Does this course make you a true  doula, or is a massage doula not techincally a doula? 

Upon completion of the prenatal and doula courses, your title will be “Massage Doula Specialist”, which in our humble opinion is far greater than just a “Doula”. Why, you may ask? Because a Massage Doula is a certified massage therapist who is also specially trained in prenatal massage (which includes training in postpartum massage), trained as a doula, and also has the option of being trained in Infant Massage. As a client, who would you want to hire? Someone who can 1) massage you during your pregnancy (thus getting to know your body, your preferences, your normal levels and areas of tension, prepare your body for labor, etc), 2) be with you in labor as both a massage therapist and doula, 3) perform massage postpartum, and 4) potentially teach you to massage your infant? Or someone who can serve as a doula in labor, but nothing else? A massage doula brings FAR more to the table.

How do I locate prospective mothers for my internship?

Being willing and able to get your name out to the prenatal and birthing community will take some effort on your part, as you probably already realize. We address that need as part of the class curriculum. We have a large segment on marketing and sales that can help you find the pregnant women for your prenatal documentation, as well as for the doula internship when you get to that stage. Our free sample course, Seven Mistakes Massage Therapists Make has lots of ideas in it that could help you set up for success. (Access it on our home page where it says to take a free sample course, or on our list of courses page alphabetically listed.)     


I am currently in massage school. Can I start taking your pregnancy massage and doula courses now so when I become licensed I’ll be ready to work on pregnant women?


Yes. Many massage therapy students begin taking continuing education courses as they near the end of their schooling. You can do this not only with our pregnancy massage course, but with any of our other specialized courses as well. Just be aware that you cannot legally practice until you have any massage license that your jurisdiction may require.     


Do I have to be a licensed massage therapist or massage therapy student to take your courses?


While our courses are designed as continuing education for licensed and/or certified massage therapists or athletic trainers, a non-licensed person may take them for their personal use. Of course, they may not legally practice without an underlying license if their jurisdiction requires one, as most jurisdictions do. Exceptions to this are courses such as the pregnancy massage and infant massage training. 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 prenatal massage specialist or massage doula specialist without having a massage therapy certification or license.    

I've already attended several births. Can these be counted?

No. While we recognize that the births gave you valuable experience, the entire purpose of the internship births is for you to practice the techniques that we teach in the course. If you have not yet studied these techniques, it is not reasonable to assume that you practiced them in the births.    

How long do I have to complete the course once I enroll?

You have one year from the date of enrollment to complete the course. If for some reason you have extenuating circumstances that don't allow you to complete your internship births in that time frame, please contact us. You may also have your courses reinstated for a second full year for a $35 reinstatement fee.    

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.    


What type of documentation do you require for the internship births?


We provide the paperwork. There will be forms that you complete (a birth record and birth essay), and an evaluation form that your client completes. We do not require that you get evaluations from attending nurses and physicians. Not only are they already overwhelmed with their own paperwork, but often they are not present during most of the labor, so they are not really in a position to provide thorough and complete feedback of your role.  

Do I need a separate license to work as a doula?

We are not currently aware of any states that offer doula licensure, nor are we aware of any states that exempt doula labor support from their massage therapy scope of practice, so your massage license should be all you need. State laws are always subject to change, and your state massage board holds you responsible for knowing the laws that apply to you. If you live in a jurisdiction that decides to exempt labor support from massage therapy scope of practice, you would need to separate and differentiate your licensed massage practice from your labor support practice.   

Will my training be acknowledged by DONA?

No. We are not affiliated with DONA, or any of the other doula certifying agencies, such as ICEA, CAPPA, ALACE, etc. Those agencies are not specifically designed for massage therapists. With our three-part series, you will be trained to provide prenatal massage, massage and doula support through childbirth, and postpartum massage. We also offer training in infant massage. DONA or other similar agencies only teach you to provide doula support through childbirth, but do not teach prenatal massage. Their courses also do not give you massage therapy continuing education credits.    

Course image credits: Photo by Unknown Author is licensed under CC BY-SA

PRESS RELEASE: Massage Therapy in Doula Services 

Adding massage therapy techniques to doula services can greatly expand the benefits that you can bring to your birthing clients. Massage therapists serving as doulas, or doulas incorporating aspects of massage therapy into their practice, can help their clients prepare for labor, get relief during contractions, and unwind between contractions, to help the birthing process go more easily. Massage doulas have different roles during each segment of the birthing process. 

Before Labor 

During the final weeks leading to the due date, a massage therapist will help loosen the hip and pelvic areas, allowing a greater level of laxity in this region. By getting rid of unnecessary tension here, the involved muscles can more easily release for the opening of the birth canal.  

The massage therapist will assist the overall relaxation of her client, affording the client the luxury of going into labor beginning from a point of relaxation. By performing regular massage therapy during the final several weeks of pregnancy, not only is the client as loose and relaxed as possible, but it also helps both the therapist and the client recognize what is normal, and abnormal, levels of tensions in various parts of her body. This helps the therapist better know her client’s patterns of muscle tension (to recognize unusual tension during labor) and it helps the client develop proprioception (awareness of her muscle laxity or tension). This is of great help during labor as the therapist will be able to identify abnormal patterns of tension, and the client will be more aware to mentally release the involved muscles.  

For clients who are at risk of perineal tears or episiotomy, a doula can teach the client perineal massage, to prepare the tissues in this area to stretch and release.    

During Contractions 

It is completely normal for women to build up tension during contractions. However, if nothing is done to counter that tension between contractions, it will grow with each contraction. As this continues, she will eventually get to a point where she is overwhelmed and unable to relax and work with her body during contractions. Given that we have a finite amount of energy available to us at any time, the more energy the client is using with extraneous muscle tension, it is that much less energy available for the real work at hand – the opening of the cervix. However, if after each contraction, the massage doula can loosen the tightness that was built and bring the client back to a lower level of tension, the client can stay within a manageable level of pain, and her body can work in the most efficient level possible.  

During contractions the massage doula will observe her client to watch for any areas of muscle tightening. She will verbally point it out, as well as touch the area to help direct the client’s attention to the tightness. This touch is often done in the form of a gentle jostling or vibration.  

The massage doula will also help to back up the partner or birth coach by helping to direct relaxation breathing techniques and to give emotional encouragement and support. Talking her through each contraction, with suggestions, breathing reminders, and affirming statements, will help keep her mind from focusing on pain.  

Between Contractions 

Far from being a time to catch her breath, a massage doula will be working between contractions. This is a time to strategize for the next contraction; perhaps it is time to consider a change of position, a technique for turning an occiput posterior baby, a different visualization or breathing pattern to try. But her main focus will be massaging any areas where she observed tension during the contraction.  


The most common areas for a laboring woman to hold tension are in her jaw, fists, shoulders, lower legs and/or ankles and feet, and buttocks. As such, these are the areas where massage between contractions is most likely going to be needed. You will notice that the tension will roam the client’s body. She might start holding tension in one location, but between your mid-contraction reminders and post-contraction massage, she may let go of that tension only to have it start showing up in other areas.   

Most clients prefer the feel of lotion over oil, as it tends to soak in better and not leave a greasy, slippery feel. Unscented is usually the best, as often a laboring woman is hypersensitive to smell. What she thought was a soothing scent during the prenatal massages has the potential to have her retching when she is in labor. The general recommendation for aromatherapists is to dilute oils 50% for pregnant women, and another 50% or more for labor, or forego their use entirely.   

Some basic guidelines for massage, regardless of the area in question, is to keep the major strokes toward the direction of the heart, to assist the body’s venous blood flow. The pressure should be firm, as light strokes can set off a tickle response which is counterproductive to the relaxation you are trying to achieve. It is also important to vary the location and type of massage every few strokes. A repetitive, monotonous touch can quickly become an irritant, causing the client to increase tension instead of relax. Pay attention to non-verbal cues: breathing changes can indicate that you are using too much pressure, while sighs can mean that feels good, keep it up.   

Feet – Major points to massage on the foot include the big toe, which corresponds to the head. Practice on yourself, and see how good firm strokes on the entire surface of the big toe feels. Carry that stroke around the outer border of the toe, giving firm strokes along the entire length of the toe, which represents the head, and circle the base of the big toe, which represents the neck. Carry these strokes down the entire arch of the foot, which corresponds to the spine. When you arrive at the heel, this corresponds to the sacrum, an area that feels a lot of pressure during labor.   

Hands – If your client is clenching her fists, you can stretch out the overworked muscles by placing your hand palm-to-palm with hers and pressing your fingertips against hers to stretch her fingers back. As soon as you feel any resistance, stop and hold for a moment. You can also interlace your fingers with hers and take her wrist through range of motion, circling it clockwise, then counterclockwise, as well as stretching the palm forward and backward to stretch the muscles of her forearms. Be mindful of meeting her natural level of flexibility so that you do not overstretch. A different technique is to gently grip both of your hands around her closed fist and ask her to gently try to open her first against your resistance. Making inching motions with your thumb, “walk” the entire length of the outer edge of the thumb, from nail to wrist, and follow to the outer edge of the other wrist. Just as the big toe and arch did on the foot, the thumb and wrist correspond to her spine. Every part of the fleshy palm should feel good to have massaged. The webbing between the thumb and hand has an acupuncture/acupressure point that is beneficial for pain relief.   

Shoulders and Neck – Gliding strokes along either side of the spine, from the base of the shoulder blade to the base of the skull, and fanning out along the shoulder blade, can help alleviate tension in the neck and shoulders. Rather than direct pressure on the spine itself, focus on the muscles that attach along the vertebrae and run parallel to the spine.   

Jaw/Scalp/Ears – Just like the feet and hands, the ears have full body reflexology zones. Use your fingertips to massage the scalp (think of a shampooing motion), which can continue along the jawline. Include the back of the ear where it meets the scalp, then firmly rub the entire surface of the ears between your thumb and index fingers. Using both thumbs, firm strokes starting from the center of her forehead and going out to the hairline can help release tension.   

Low back/buttocks – Use gliding strokes along either side of the spine, from the base of the ribs to the base of the sacrum. Deep pressure strokes into the fleshy part of the gluteus maximus can also help bring relaxation to this often overlooked area of stress-induced tension.   

Our prenatal massage and massage doula courses can help you incorporate massage therapy into your doula practice. The benefits to you and your client will be many.   

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About the Author: Judith Koch Stapleton has been a massage therapist since 1991, and a massage doula since 1993. She is the founder, owner, and Director of Education of the Institute of Somatic Therapy. Her courses are approved by numerous US and Canadian massage therapy boards for certifying massage therapists in prenatal massage, massage doula support, and infant massage. Her websites are and