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

This special certification package contains three courses,

  1. Prenatal Massage Fundamentals (Step One)
  2. Prenatal Massage Techniques (Step Two)
  3. Massage Doula Support (Step Three)

Please click on each individual course for a complete description of each one.

Tuition: US$497 before discount. Package Special Prices: This package qualifies you for our Create Your Own Customized Discount Package. In our customized packages, you can receive a discount of 8%-15% (depending on tuition value) when you enroll in any three or more of our courses at the same time. This complete package counts as three courses, since it includes Prenatal Massage Fundamentals (Step One), Prenatal Massage Techniques (Step Two) and Massage Doula Support (Step Three). (All amounts are in US Dollars)

Please note that our package specials are non-changeable/non-refundable. You have one year from enrollment to complete the courses.

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 return the homework documentation pages along with a certification fee of US$35.00. This process is done online for no additional processing fee, or by mail for a manual processing fee. 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.

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.        

Becoming Certified: To earn the title of "Certified Massage Doula" (CMD), you must complete all three courses in the package 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.

Renewing Certification: 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. We have many ways that you can earn points towards maintaining your Massage Doula certification. Some of the many ways to earn points include:  1) Attending a workshop relevant to doula practice, such as rebozo or Hypnobirthing, or earning related certifications such as childbirth educator, lactation consultant, etc. 2) Have an article published in a local or national publication. 3) Make a presentation to the doctoral or nursing staff at a local hospital or birthing center. 4) Make a presentation to a parenting group, La Leche League meeting, or childbirth education class about the value of doula services. 5) Attend La Leche League meetings. 6) Read books related to pregnancy, childbirth, or postpartum issues.

Frequently asked questions (FAQs):

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.

If you are interested in this massage therapy CEU course, other courses that might be of interest to you are:  Infant Massage, and Fertility Massage.

To contact the Institute of Somatic Therapy about this or any other massage therapy CEU course, please go to the "contact" link above. Thank you.


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