Certified Massage Doula

Becoming a Certified Massage Doula: Empowering Births Through Compassionate Care

The role of a doula is one of profound importance—a pillar of support during one of life’s most transformative experiences: childbirth. By becoming a Certified Massage Doula, you expand your ability to guide, comfort, and empower birthing individuals while integrating the therapeutic benefits of massage into their journey. This certification is not just a credential; it is a calling to provide holistic, physical, and emotional support during labor and delivery.

Our program is designed to equip you with comprehensive knowledge, hands-on skills, and the confidence needed to become an indispensable resource in the lives of expectant families. If you're passionate about supporting people during pregnancy, labor, and postpartum, this is your opportunity to elevate your career and make a lasting impact. 

The Unique Role of a Massage Doula

A massage doula is a professional massage therapist who combines the nurturing support of a traditional doula with advanced massage therapy techniques to ease discomfort, promote relaxation, and facilitate an empowered birth experience. This dual approach addresses both the emotional and physical needs of the birthing individual, making you an invaluable part of their journey.

Benefits of Massage Doula Support:

1.  Physical Comfort: Massage reduces pain and tension, improving labor progress and relaxation.
2.  Emotional Support: Encouragement and reassurance foster confidence in the birthing process.
3.  Holistic Approach: Massage complements natural and medical interventions, enhancing the overall birth experience.
4.  Better Outcomes: Studies show that doula support can reduce the need for medical interventions, shorten labor, and improve postpartum recovery.

As a certified massage doula, you will empower clients to approach childbirth with strength, calm, and confidence. 

What You’ll Learn in Our Certified Massage Doula Program

Our program provides a comprehensive education that prepares you to support clients at every stage of their journey, from pregnancy to postpartum. By combining traditional doula training with advanced massage techniques, we ensure you are uniquely positioned to offer unparalleled care.

Core Curriculum Highlights:

Foundations of Doula Support

• Understanding the role of a doula in labor and delivery.
• Building communication and emotional support skills to connect with clients.
• How to advocate for clients while respecting their choices and birth plans.
  
  Anatomy and Physiology for Childbirth

• The stages of labor and how the body prepares for birth.
• The effects of pregnancy and childbirth on muscles, ligaments, and joints.
  
  Massage Techniques for Labor and Delivery

• Targeted massage methods to reduce pain and discomfort during labor.
• Counterpressure, sacral massage, and hip-opening techniques to aid labor progress.
• Techniques to relax and center the birthing individual, encouraging hormonal balance.
  
  Prenatal and Postpartum Care

• Tailored massage for each trimester to address pregnancy-related aches and promote relaxation.
• Postpartum massage techniques to aid recovery, ease tension, and restore balance.
  
  Partner and Family Involvement

• Teaching partners how to provide effective support during labor.
• Strengthening the client’s support network for a holistic birthing experience.
  
  Professional Doula Practice

• Managing the business side of your massage doula practice, from marketing to contracts.
• Ethical considerations and maintaining boundaries in your work. 

Why Become a Certified Massage Doula?

There is a growing demand for professionals who can provide compassionate, integrative care during childbirth. By becoming a Certified Massage Doula, you position yourself at the intersection of massage therapy and birth work, a unique niche that sets you apart in both fields.

Career Benefits:

• Enhanced Skills: Stand out by offering both massage therapy and doula services.
• Flexibility: Work in a variety of settings, including homes, birthing centers, and hospitals.
• Increased Demand: With more families seeking holistic support during childbirth, your services will be highly sought after.
• Personal Fulfillment: Make a profound difference in the lives of clients and their families. 

Certification That Sets You Apart

Our Certified Massage Doula program meets the highest standards in both massage therapy and doula training. Upon completion, you will earn a professional certification that demonstrates your expertise and dedication to excellence. Certification enhances your credibility and gives potential clients confidence in your abilities.

Whether you are an experienced practitioner or just beginning your journey, this program is designed to meet you where you are and help you achieve your goals. 

The Value of Massage Doula Training

Becoming a massage doula is an investment in your career and your clients' well-being. By integrating massage therapy with doula support, you create a comprehensive service that fosters trust, comfort, and empowerment during childbirth. The knowledge and skills you gain in this program will not only elevate your career but also make a lasting impact on the families you serve.

Start Your Journey Today

As an educator, it is our mission to guide you toward achieving your full potential as a Certified Massage Doula. The work you do will transform lives, bringing comfort and confidence to families during one of their most vulnerable moments. With our expert training, you will emerge as a leader in the field, ready to empower clients with the care they deserve.

Enroll today and take the first step toward a rewarding career that blends compassion, skill, and purpose. Together, we will shape a future where every birth is supported by the power of skilled, nurturing care.

For more information or to begin your journey, contact us today. We look forward to welcoming you into this life-changing profession.  

Our Students Say:

"I took the complete DONA workshop (pre, post, lactation etc. given by a former president of the organization 15 years ago. It was very good. I enjoyed it, but I found your information and breakdown of the birthing process, videos of this, interventions and videos of this, medical terms, and personal testimonies very helpful. It reached my understanding more and gave me deeper clarity.

I chose your course because it embodies exactly what I envisioned as a skill set. I'm very grateful I found this opportunity. Thank you for your hard work and sharing your experience." --Joyful Felts, Georgia

"Thank you so much. I did not expect to enjoy these courses (prenatal steps one and two) as much as I have. I just purchased the doula class and I'm sure I'll be taking the infant massage course, as well. Thank you so much for helping me grow my business and become more passionate about my craft." Whitney Brown, Bremen, Kentucky

"Thank you for all of your help with this course. It's an awesome course! I've taken a few other Prenatal massage courses and found yours the most comprehensive. Thanks again." Patti Nebel, Wenonah, NJ

"Thank you for offering this course!!! It was very easy to follow, the information was very thorough, and it was a convenient and more affordable alternative to other prenatal courses. As a licensed massage therapist, I strongly believe in the benefits of prenatal massage - for the mom-to-be and the baby. This course gave me everything I need to confidently incorporate prenatal massage into my practice. I ordered this course along with the Doula course, and am really looking forward to obtaining Doula certification next." K. Jackson, Las Vegas, NV

"Thank you for developing such a wonderful course! My massage office is located within a birth center & I have been giving pre & post natal massage for 6 years now, I LOVE it!! I have read several books and watched a few DVDs on the subject and the information in your workbook & DVD is by far the best. I have learned so much & am so excited to share this info with my clients. Thanks you. Heather Barber LMT" Palmer, Alaska

"I have been a holistic therapist for the last 27 years and have invested a lot of money in furthering my education. Some courses were worth it...many others weren't. I love the courses you offer not only because there is so much to choose from but also because all is actually applicable! So many times I have taken courses and half of what was being taught had absolutely no relevance. Your courses are of high quality and they are relevant - that's the most important aspect for me. I know I'll be back for more :)  Cheers, Gabriela Eikeland"    Campbell River, British Columbia, Canada. Courses Gabriela has taken: Manual Lymph Massage, Prenatal Fundamentals, Prenatal Techniques, Spa Fundamentals, Communicable Diseases

About the Instructor: Judith Koch Stapleton

Judith (Judy) Koch Stapleton has been a passionate and accomplished professional in the massage therapy field since 1991. Inspired by a book that emphasized pursuing a career you truly love, Judy transitioned from her role as a successful sales trainer and manager to follow her calling in massage therapy. Her journey began with a simple realization—her knack for offering neck and shoulder massages to her team, combined with her love of receiving massages, pointed to her true vocation. It wasn’t long before she discovered that clients preferred her as their massage therapist rather than their sales manager, and she never looked back.

Early in her career, Judy's path took a transformative turn when three of her regular clients became pregnant within weeks of each other. Determined to meet their needs during this critical time, she overcame traditional misconceptions that pregnancy was a contraindication for massage. She flew across the country to attend an advanced certification course in prenatal, labor, and infant massage. This decision opened the door to a specialized field that would become her professional hallmark. Captivated by the transformative impact of prenatal massage and the little miracles she witnessed, Judy developed a profound passion for supporting expectant mothers. Her commitment to excellence earned her national certification status in 1993, and her business quickly flourished.

Judy’s expertise and dedication have been recognized widely, with her work featured in local newspapers, television health segments, and national publications such as Massage and Bodywork Quarterly and Parenting Magazine. Over the years, she has provided thousands of prenatal massages and attended nearly 100 births. Her clients consistently experienced exceptional outcomes, including average labor durations of about four hours, with most births being drug-free.

Recognizing the importance of continuous learning, Judy expanded her skills early in her prenatal massage career by training as a doula. Inspired by the concept of providing emotional and physical support to laboring mothers, she pursued advanced training with Penny Simkin, a pioneer in the U.S. doula movement. Through this experience, Judy mastered a variety of techniques to ease labor and assist during delivery. While her certification with Doulas of North America (DONA) was delayed because her clients’ labors were too short to meet the minimum requirements, her extensive experience speaks volumes about the effectiveness of her techniques.

Judy has since developed comprehensive courses in massage therapy for all stages of pregnancy, labor, and delivery, as well as foundational techniques for infant massage and movement. These courses empower therapists to provide safe, effective, and transformative care to expectant mothers and their newborns.

Are you ready to start a career where you can witness miracles every day? Join Judy and learn how to bring comfort, empowerment, and joy to mothers during one of the most extraordinary times of their lives.

PRE-REQUISITE:  Prenatal Massage certification through the Institute of Somatic Therapy - this three part series covers Pregnancy Massage Myths, Prenatal Massage Fundamentals, and Prenatal Massage Techniques. (You may take just this doula portion if you have earned prenatal massage certification elsewhere, however, you are not able to earn the doula certification 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.

CE Hours Earned: 21

Tuition: US $229 for this Doula Portion. 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 package counts as three courses, since it consists of Prenatal Massage Fundamentals (Step One) and Prenatal Massage Techniques (Step Two) and Pregnancy Massage Myths. Please note that our package specials are non-changeable/non-refundable. You have one year from enrollment to complete the courses.    

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.

Instructor: Judith Koch Stapleton

Course Description: If you wish to become a Massage Doula, you must already be a prenatal massage therapist, by having taken our Prenatal Massage certification  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 "Certified Massage Doula", 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.  

Earning your CEs and/or certification title:

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 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 Certified Massage Doula.

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: 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.”

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 

What does “doula” stand for? What does a doula actually do?

“Doula” is a Greek word for “handmaiden” or “female servant”. (Doulo would be the term for a male servant.) The role of a doula is to be with a birthing mother through the entire active stage of labor until after the baby is born, the placenta delivered, and the mother is resting comfortably. During that time, the doula will provide three general types of support: 1) Emotional support, by giving encouragement as appropriate to both the mother and her partner, 2) Physical comfort, by helping to relieve back labor the stress and tension that will build during contractions, and 3) Information, to help the mother understand the stages of childbirth, what to expect both during normal labor or through any complications or interventions that may arise.

What's the difference between a doula and a midwife?

A doula is there to provide emotional and physical support, along with information, to the birthing woman. She does not perform clinical exams (such as checking for dilation and effacement levels), and does not actually deliver the baby. The doula is focused solely on the mother, and her partner as appropriate.

A midwife may also perform any of those functions, but their role also includes that of actually delivering the baby. In essence, a midwife takes the place of the role of an obstetrician. The midwife is focused on the mother and the baby, and will provide all medical and nursing services to the baby during labor (such as fetal heartrate monitoring) and after it is born (such as suctioning any amniotic fluid from its mouth or lungs).

As such, the role of the midwife is a more complex role than that of a doula. Many midwives have extensive medical training, and may even be a nurse or hold other medical degrees. 

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 training 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 3-part series is the foundation that leads to the doula aspect of our training. 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 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 (and thus how they change massage techniques) 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 about three massages. For that very small one-time investment, you would earn 28 extra continuing education credits, get at worst a great refresher 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.  

We do not make exceptions to this policy. Thank you for understanding.

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

Upon completion of the prenatal and doula courses, your title will be “Certified Massage Doula”, 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, a non-licensed person may take them for their personal use. Of course, they may not legally practice without an underlying massage license if their jurisdiction requires one, as most jurisdictions do, at least for performing massage. Exceptions to this are courses such as the infant massage training, and in some cases, the doula training. Doulas or other prenatal healthcare providers can use the techniques we teach that fall within the scope of their training or any licensing authority that may have jurisdiction over them. You cannot, however, hold yourself out to be a "massage therapist" or "massage doula" 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.  

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.

Techniques

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 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.