Massage Therapy CEs | Prenatal/Doula/Infant Courses
Certified Massage Doula
PRE-REQUISITE FOR CERTIFICATION (Click for details or to enroll): Certified Prenatal Massage Therapist package
(You may take just the doula portion if you have earned prenatal massage certification elsewhere, however, you are not able to earn the certification title through us if you have not completed the prenatal certificaton with us.)
Tuition for this Doula Certification Portion: US $229
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 certifications 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 certification 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 earn certification as a Massage Doula, you must already be a certified prenatal massage 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:
- Provide physical comfort, information, and emotional support during childbirth
- Describe and explain the medically proven benefits of continuous labor support services (also known as doula services)
- Describe and understand the physical processes that make up the three stages of labor
- Study common interventions in labor
- Study some of the possible complications that can arise in labor
- Suggest a number of various positions for laboring that decrease discomfort and back labor, and promote more effective pushing
Table of Contents:
- Labor Support Providers Terminology and Roles
- Benefits of Labor Support
- Long Term Perceptions of Childbirth
- Comparison of Father to Professional Support Provider
- Stimulating Labor Naturally
- Breech Presentation
- Special Needs in Labor
- VBAC information
- Stages of Labor
- Terminology You’ll Hear During Labor
- At the Hospital
- Common Interventions in Labor
- Possible Complications in Labor
- Birth Stories
- Back Labor
- Stage Two – Pushing
- Equipment List
- Pricing Your Services
- Miscellaneous Recommendations
- Recommended Reading
- 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 "Certified Massage Doula" (CMD), 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. Your clients must be willing to sign an evaluation and release allowing you to provide their birth record, along with their name, address, and phone or email address so that we can verify the internship sessions. Your certificaiton is valid for three years. You will need to recertify every three years at a cost of $35. To recertify, you need to attend three births during the renewal period, as well as accumulate points on a renewal point system. (See FAQ below for more on the point system.)
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.
Certification: 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 Certified Massage Doula, you must complete the online homework documentation along with a certification fee of US$35.00. Refer to the course certification chapter instructions for details when you are ready to apply for certification. Neither the NCBTMB nor any state massage therapy boards make a determination on the awarding of the title of Certified Massage Doula.
To earn the title of "Certified Massage Doula" (CMD), you must complete the prenatal massage certificaton first. You must also read The Birth Partner by Penny Simkin (you must provide your own copy of the book), and attend three births as a doula intern. Your clients must be willing to sign an evaluation and release allowing you to provide their birth record, along with their name, address, and phone or email address so that we can verify the internship sessions.
Recertification: You will need to recertify every three years by attending three births and documenting 12 points on a renewal point system. Points can be earned for activities such as making presentations about doula services to doctors or nurses, writing articles about doula services, attending LaLeche meetings, reading books, etc.
COVID: Please note that due to COVID, we are giving grace periods on submitting documented practice sessions as long as you completed your online exam in the one year period. Because we do not know at this time how long COVID will interfere with your ability to perform practice sessions, we cannot give time periods. We can only assure you that we will be reasonable in allowing you sufficient time to complete this process.
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: https://www.who.int/news-room/detail/09-09-2020-every-woman-s-right-to-a-companion-of-choice-during-childbirth. 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.”
Frequently asked questions (FAQs):
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 certification 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 certified prenatal massage therapist 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 those 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 certification 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.
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.
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.
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.
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 www.massagedoula.com and www.massagecredits.com.