What You Need to Know About Doing Pilates During Pregnancy

Studies have shown that physical exercise carries minimal risk during a healthy pregnancy (1).

Pilates, with its low impact emphasis on stabilizing the joints, can eliminate or manage many of the typical pregnancy-related aches and pains (5, 6).

That said, you always should consult a prenatal healthcare professional before embarking on or continuing any exercise program when pregnant.

Some conditions may qualify a pregnancy as high risk, such as certain heart and lung conditions, placenta previa, or conditions that could cause preterm labor. In these cases, most, if not all, exercise is contraindicated.

A lot is happening physiologically when you grow a human.

The pregnant body experiences an increased blood volume, heart rate, and cardiac output, causing you to feel short of breath.

Pilates breathing not only calms the nervous system, thereby lowering blood pressure, but also helps build the stamina required for the mental and emotional strength of labor and delivery (1, 2, 7).

Pilates has been shown to aid postpartum recovery and lower rates of cesarean deliveries (also known as C-sections or cesarean sections), birth interventions, episiotomies, and preeclampsia (1, 2, 3).

With an emphasis on the abdominals, back, and pelvic floor, prenatal Pilates increases body awareness and prepares you for pushing. It decreases back pain and has been shown to aid with sleep (1, 2, 3, 6).

Furthermore, the involved diaphragmatic breathing and coordination of breath with movement patterns are likewise beneficial.

But Pilates and exercise are not only good for mama, baby also reaps the benefits!

When a pregnant person continues to exercise safely during pregnancy, their baby is less susceptible to certain illnesses and benefits from a jump start in brain growth and development (8, 9).

Studies have shown there are numerous benefits for Pilates during pregnancy, both for those who may have been sedentary before, as well as the avid exerciser (1).

Due to the amount of blood flow and respiratory changes experienced during pregnancy, it’s important to stay hydrated and refrain from overheating.

Your body prepares itself to accommodate a growing baby and eventual birth by producing hormones that relax connective tissues around the joints.

This increased mobility and flexibility, along with a changing center of gravity as the baby grows, can exacerbate misalignments and previous injuries.

Fortunately, Pilates helps address, manage, and alleviate these concerns, all while giving you a challenging workout.

Still, every stage of pregnancy has its own guidelines, and there are some exercises better left for after pregnancy.

First trimester

The first trimester is the beginning of a journey during which your body starts internally working hard in preparation for baby. As your uterus begins expanding and hormonal changes begin, fatigue, nausea, or both usually set in.

Most Pilates exercises can still be performed during this stage; however, it’s important to listen to your body to refrain from overexertion. This isn’t the time to advance your practice.

Think simple. Breathwork can calm the mind, reducing anxiety while oxygenating and energizing your body.

The Pilates repertoire for strengthening the backside of the body (think glutes and hamstrings) counteracts any anterior pelvic tilts that may be starting. Pay attention to your range of motion and aim not to move through your joints’ end range with your newfound flexibility.

Second trimester

This is typically the feel good stage of pregnancy during which any fatigue and nausea have subsided and a growing bump is more visible. Your center of gravity shifts, challenging your balance, endurance, and coordination.

Lying on your back should be kept to a minimum. The uterus can compress the vena cava (a major vein), restricting blood flow to your baby.

To modify exercises, supportive props can be added to elevate the upper body, the reformer can be elevated on an incline (also increasing the difficulty of legwork), and there are plenty of side-lying exercises to strengthen and stabilize your body.

Full planks and forward-flexing abdominal exercises increase intra-abdominal pressure, contributing to diastasis recti (separation of the abdominals) and additional downward pressure on the pelvic floor muscles.

It’s best to avoid these exercises for now — don’t worry, there are plenty of other ways to strengthen your core.

Prenatal Pilates focuses on activating the transverse abdominals that wrap around your torso like a corset, giving the feeling of “hugging the baby” while lifting the pelvic floor muscles simultaneously.

Still, it’s equally important to relax both the pelvic floor and abdominal muscles. Muscles that are too tight or overactive can lead to pelvic floor dysfunction.

For obvious reasons, at this stage, any prone (lying facedown on your stomach) exercises will need to be avoided. Modifications to replicate prone exercises can be done instead.

If you’re not already working with an instructor who’s trained in prenatal Pilates, you’ll want to start now. Some of the modifications mentioned above require expert knowledge, and their expertise will guide you to pick suitable replacements for contraindicated exercises.

Third trimester

As you progress in the third trimester, the energy from the second trimester begins to dwindle while your bump grows larger.

The guidelines from the second trimester are still relevant, with the focus turning toward both contraction work and reverse Kegels to relax and release the pelvic floor muscles, as well as a full range of motion throughout movements.

This is the phase in which to concentrate on birth preparation.

An ever-increasing bump can exaggerate spinal curves, round your shoulders forward, and pull your lower back toward lordosis. Pilates exercises that continue to open up the front of the body and strengthen the back are still vital.

At this point in your pregnancy journey, you may feel you gain the most benefit from gentle mobility and stretching.

Try not to put too much pressure on yourself to get stronger or meet other fitness goals during this time. Your body is already preparing for the biggest athletic event of its life.

Your body is doing a lot of work during pregnancy — this isn’t the time to push or advance your practice. It’s an opportunity to tune into your body, listen, and let it direct you.

Stop exercising and contact your healthcare professional if you experience any of the following:

• vaginal bleeding
• dizziness
• headache
• unusual shortness of breath
• abdominal pain
• regular painful contractions
• chest pain
• amniotic fluid leakage
• calf pain or swelling

Heeding these guidelines will help you reap the most benefit from your prenatal Pilates routine.

• Always work with an instructor that has extensive prenatal training.
• Wear light, comfy clothing.
• Remember to consult a healthcare professional or a pelvic floor physical therapist before beginning.
• Avoid holding your breath.
• Hot Pilates or exercising in hot and humid conditions is inappropriate.
• Always have snacks on hand and stay hydrated.
• Using specialized equipment like the Reformer or Cadillac/Tower (especially in the later months) offers resistance training and a more comfortable positioning due to their elevation off of the floor.
• When using the Pilates Reformer, consider heavier springs for added support during exercises when the carriage is supporting you, and lighter springs for exercises in which you’re pushing the weight.
• Take your time when coming up from the floor.
• Relaxing your pelvic floor muscles and abdominals is as important as contracting them.
• If possible, allow time after your session so you don’t have to rush. Recovery is just as important as the workout.
• Your joints have more laxity, so be conscious of not overstretching.
• Have fun and aim to stay in tune with your body.

Pilates has been shown to lower rates of cesarean birth, birth interventions, and episiotomies, and it helps manage or eliminate the typical aches and pains associated with pregnancy.

Pilates can support every stage of pregnancy, birth, and the postpartum period. Whether you’re a newbie or avid exerciser, a qualified instructor can gear the workout to meet your needs and still challenge you safely.