Online Course & Online Test

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

Massage Therapy CEs | Prenatal/Doula/Infant Courses

Massage Doula Support (Step Three)

Pre-Requisites: Prior to completing this course, you must first complete (Step One) Prenatal Massage Fundamentals AND (Step Two) Prenatal Massage Techniques. You will not receive your Massage Doula  Certification until you have completed all three steps. Enroll on this page ONLY if you have previously taken prenatal steps one and two. Otherwise, for the complete package, enroll on our Doula Certification page, found here.

Massage Therapy CEs awarded: 21. The average massage therapist should expect to devote one clock hour for every CE credit earned, based on NCBTMB calculations. These are online home-study hours. They are not "live" classroom hours.

Course classification: Cognitive (course materials consist of concepts related to massage therapy but do not teach a specific hands-on modality)

Approved by: Institute of Somatic Therapy (Judith Koch) is approved by the NCBTMB (Provider #280672-00) as a continuing education Approved Provider. Institute of Somatic Therapy is approved by Florida (#MCE-326), and New York (#0019). Our courses are also valid for AMTA, ABMP, and most individual states. Some states limit how many hours can be done online or by home study. Please refer to our State Guidelines section for specific information about your state. Laws can and do change, and your state will hold you responsible for knowing the laws that apply to you.

Canada Massage Therapy approval, acceptance:  This course has been approved by the Massage Therapists' Association of Nova Scotia for 10.5 primary CEUs. (One CEU is equivilent to two clock hours of instruction.) Effective April 3, 2018 - April 3, 2020, this course is approved by the Massage Therapy Association of Manitoba for 21 primary/core competency credits. It also meets requirements for Ontario (CMTO), NHPC in Alberta, and is potentially valid for other Canadian assocations. Please refer to your individual association rules to determine if this course is valid for your Canada massage therapy continuing education requirements.

Tuition: US $229  

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 $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.

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. 

Package Special Prices: Sign up on this page if you have previously completed steps one and two and now want to take ONLY Step Three. If you are interested in taking several of our related courses at once to receive a discounted tuition, please see our Create Your Own Customized Discount Package. 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.

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

View sample video: By visiting our YouTube site, you can preview samples from this and some of our other online CEU courses, at

Testing:  Upon completing the online test, you will be able to print a certificate for your CEs. In order to earn the certification title, you must also submit additional  homework requirements in paper format, including required reading, attendance of childbirth education classes and internship births.

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.

Attention Florida & Georgia massage therapy licenseesInstitute of Somatic Therapy will automatically report your hours to CE Broker 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. 

Frequently asked questions (FAQs):

How long will it take me to complete this course? The number of massage continuing education hours awarded was determined by the NCBTMB, although not everyone reads and studies at the same rate. Some massage therapists report that they are faster or slower than the number of CEs awarded. The theory is that it should take the average person one clock hour for every CE earned, so a 21 hour course should take you 21 actual hours to complete. The NCBTMB does not count the three births into that time as they are practice, not educational, hours. You can work on the course at your convenience and set your own schedule. Just be sure to complete the online exam  within one year of enrollment, or it will expire.

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.

Where can I find the certification homework documentation paperwork? It is located in the course materials, in the PDF file. Just log into your account, click “access course” to the far right of the course title, and then access the course materials. From there, look to the right at the PDF file section.

I've taken prenatal massage elsewhere. Can I skip Steps 1 & 2 and go directly to Step 3? No. It isn't to be unreasonable, but rather because we have seen, even among "big name" educators, a wide variation on prenatal massage courses. We are not in a position to assess every single prenatal training course in the country to determine how closely it matches our curriculum. We have decided that it is better that you take a chance of some redundancies than take a chance that you don't learn something important that could help your clients in labor. We've had many people who had previously taken prenatal training elsewhere tell us how much more comprehensive our online course was than what they already took as live classroom hours. I hope that you will find the same to be true if you decide to pursue your doula training from us.

You of course have the option of taking just doula training from a variety of other sources, such as DONA, but you will find that the cost of their entire process is still more than our 3-part series, and it won't even earn you massage CEs for your continuing education needs, so you really gain nothing by choosing them over us.  (For example, the last we checked, the DONA doula course in Brooklyn, NY was $595, only for doula training, without prenatal massage. One in Ohio was $425 for just doula training.) Going directly through them will not save you any money, nor will it give you the opportunity to refresh your memory on many valuable topics, most likely pick up pre- or post-natal massage techniques you had never learned, and be fully prepared for attending births as a massage doula.

When you consider all of the options, you will likely agaree that you are better off in a variety of ways by taking our three part series and earning your massage doula certification through us.

You can also take this step alone, without steps one and two, if you just want the information, but you will not qualify to earn the massage doula certification title if you do this. Steps one and two have important information that step three builds on, and we cannot certify someone who has not completed the entire process.

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.

I took a childbirth education class when I was pregnant. Can that be counted? No. When you were pregnant, you had a different mental approach to the information you were learning. We want you to filter it through the lens of a doula student this time. Plus, you don't want to miss an opportunity to meet another childbirth educator (who could become a great referral source for you) and a room full of pregnant women (who could become potential clients for you).

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.

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.

How do I find women for the internship births? Do you help me find them? You will find your internship clients the same way you will find paying clients - through marketing your services. We do provide a detailed list of ways to market your services in the Step One portion of our training, but we do not help you find your clients. Attending the childbirth education class is also great exposure toward finding potential clients.

What type of documentation do you require for the 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.

What should I charge for my services? We cover this as part of the course, as there are several factors to take into consideration. For a general idea before enrolling, you might want to see what doulas in your community are charging, as fees do vary widely from area to area.

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.

Do you offer this seminar in a live classroom setting, or only online? This course is currently only offered online. With the expense of travel and lodging for our instructor, plus her salary, plus profit and expenses for hosting schools, the tuition would be triple of what it is online. And that isn’t counting the money you would lose (lost work, potential travel expenses, etc) that would cost you on top of tuition.  For more on the advantages and disadvantages for live and online courses, check out our blog post on this topic

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.

Can I print the online test to work on it at my convenience? Yes. We provide a study guide with this course that has the test questions and answer choices. You can print it off and work on it as you study. When you are ready to take the test, you will log into the system and supply your answers to the test questions.

What is the study guide that comes with the course? The course study guide is a copy of the questions you will find on the online exam. As you study the course materials, you can fill in the answers on the guide, to refer to when you complete the online exam. We do not provide page numbers where you will find the answers to the questions, because we want you to study the entire course materials, not just flip to a page to find an answer to a test question.  Because the study guide contains the actual test questions, we do not provide an answer key. It is your job to find the answers as you study. You will get your grade when you complete the online exam.

What happens if I fail the test? Do I have to pay again? No. If you happen to fail our test, you can continue to retest until you do pass at no additional charge within your one year time frame.

Is online testing the only testing option you have available? If you enroll online, you will automatically be set up to take the online exam. If you prefer to test by mail, you can send in the completed study guide for grading. Just follow the instructions on the bottom of the study guide. There is a $20 fee for processing paper testing, which includes the premium, gold-embossed sealed certificate (online testers also have the option to purchase a premium certificate for $15).

What kind of activities will earn me points on the renewal point system when I go to renew my certification in three years? 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.

Student comments:

"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 exicted 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 has been in the massage therapy field since 1991, after taking to heart a book that encourages seeking a career doing something that you love. In her former career, as a sales trainer and manager, she would frequently give her staff neck and shoulder rubs. Always fond of receiving massage herself, she realized this was a career she would love. Once Judith began, it was obvious that this was her niche. Her first discovery was that people like their massage therapist a whole lot better than they like their sales managers. She was hooked.

Less than two years after entering the massage field, three of her regular clients all got pregnant at once. Knowing that they must certainly need massage now more than ever, but having been taught that pregnancy was a contraindication for massage, she decided to fly half way across the country to attend an advanced prenatal, labor and infant massage certification course. She couldn’t believe it -- she found a niche within her niche, and was hooked again, this time getting to watch little miracles happen as icing on the cake. She continued her massage education and achieved national certification status in 1993. Her business continued to grow. An article appeared in the newspaper. The local television news included her in one of their health segments. Massage and Bodywork Quarterly, a national massage association journal, did a story on her. Parenting Magazine did year later. As the years progressed, she has given countless prenatal massages, and attended nearly 100 births. Her mothers maintained an unbelievable average of about four hours of labor, most completely drug free.

Early in her prenatal massage career, Judith started hearing about women called doulas (from the Greek word for “servant”), who helped women during labor. Judith had been relying almost exclusively on massage to assist her clients, and she wanted to see what these non-massage therapists were doing to ease labor. She attended the doula training nearest her, and two months later again flew half-way across the country, this time to take advanced doula training from Penny Simkin, a physical therapist who was instrumental in beginning the doula movement within the United States. There, Judith discovered a range of methods to make the laboring and pushing processes easier. Her certification with Doulas of North America was actually delayed several months because her mothers were having their babies too fast to meet DONA’s minimum five hour labor requirement.   Based on her extensive training and experience, she has developed a thorough course for massage during all stages of pregnancy and delivery, as well as basic infant massage and movement. Isn’t it time you learn how to start watching miracles happen for a living?

If you are interested in this massage therapy CEU course, other courses that might be of interest to you are: Prenatal Massage Fundamentals (Step One), Prenatal Massage Techniques (Step Two),  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.