Pilates During Pregnancy

Pilates is an excellent exercise to undertake during pregnancy as it is designed to strengthen the deep abdominal and pelvic floor muscles. ‘Core stability’ helps strengthen these areas. Pilates exercises can be performed in positions such as hands and knees that are suitable for women at all pregnancy. These exercises can take the stress off the back and pelvic floor, while help position the baby for delivery. Studies have shown that pelvic floor exercises can help reduce urine leakage in women with stress incontinence and women who have to rush to get to the toilet on time.

Pelvic floor exercises are an important part of Pilates, which can be carried out on their own without a Pilates program.

Is Pilates safe in pregnancy?

It is important to check with your doctor or obstetrician before starting any new exercise program during pregnancy. If you have not done Pilates before pregnancy, it is essential to receive consult a Pilates instructor to help develop an appropriate program for your circumstances. Do not attempt any exercises on your own prior to seeking professional advice.

During pregnancy you should safely be able to perform effective pelvic floor and deep abdominal contractions, which are achieved with basic Pilates exercises. If you cannot contract your pelvic floor or deep abdominals muscles effectively, more advanced exercises may place too much strain on your joints. This is why you need to be assessed by a Pilates instructor before continuing with exercises.

A number of exercises will no longer be appropriate past mid pregnancy due to the positions required (such as lying on your tummy or flat on your back). Exercises however on hands and knees, while sitting or in kneeling positions are all likely to be safer. As your pregnancy progresses the muscles become more stretched, and it may become more difficult to achieve good contractions.

Standard Pilates classes may not be suitable for pregnant women because they may involve inappropriate positions or may progress too quickly. Clinical Pilates or studio Pilates (conducted in small groups) tend to be more appropriate. These classes normally use equipment which provide more choices while exercising, while remaining safe. Alternatively, some specially designed 'Pregnancy Pilates' classes can be found which are specifically designed for pregnant women.

How to modify Pilates during pregnancy

Nutrition and fluid intake

It is important to remain well hydrated when performing any form of exercises. You may also need to increase your calorie intake to supplement for the energy and water you have consumed while exercising. This may mean you should focus on eating a small healthy snacks while consuming extra water throughout the day. Feel free to speak to your doctor or a dietician for advice.

Keep track of your energy levels

Pilates is a 'low impact' form of exercise, which is kind to your joints. Pilates can also be modified so that it is not too strenuous during pregnancy. You must however monitor your energy levels at all times and remember not to over exert yourself during your training session. Signs that highlight the need for you to slow down include:

• Getting dizzy
• Being out of breath where you cannot talk in a relaxed tone
• Get contractions
• Bleed or start leaking fluids
• Getting Nausea
• Headache
• Feeling light headed or like fainting
• Racing heartbeat

If you do experience any of these symptoms during or after a Pilates session, stop your exercise immediately and inform your instructor. If your instructor feels necessary, they may advise you to seek medical advice.

Don’t fall

It is important to note that as you progress in your pregnancy, you will get bigger and your centre of gravity will shift forward which could affect your balance. Be extremely careful when getting on and off equipment, undertaking balancing exercises and getting up and down from the floor.

Don’t do abdominal crunches

Make sure you do avoid undertaking any abdominal crunches or curls throughout pregnancy. Using the “six pack” muscle in the front of your tummy especially as you get larger with pregnancy may increase the risk of abdominal diastasis, where the connecting tissue that holds the two sides of the stomach separates. Some degree of diastasis is common during pregnancy, however if abdominal diastasis is present, make sure you get it checked by your doctor. Abdominal crunches may also increase strain on your lower back, hence why it is advisable to avoid during pregnancy.

Don't overstretch your joints

Your joints tend to become more flexible during pregnancy as a result of the hormone relaxin. It is therefore extremely important for you not to overstretch as this may result in injury. Working within a small range of movement, working on control and core strength is more appropriate.

As your tummy gets larger and the muscles stretch, it will become more difficult to achieve a good contraction. Continue to focus on achieving a sense of activating your abdominals and pelvic floor, and don't compensate by 'squeezing harder' and activating other muscle groups.

First trimester

In your first trimester try not overdoing it, especially if you feel exhausted or nauseous. These early pregnancy feelings tend to improve later in the pregnancy.

Second trimester

In the second trimester focus on the following exercises:

• Postural exercises
• Pelvis and lower back stability
• Squatting exercises
• Arm strengthening
• Pelvic floor exercises
• Spinal stretches (gentle)

In the second trimester try to avoid the following:

• Jumping
• Abdominal crunches
• Extreme stretches
• Unsupported back bends
• Unstable balance exercises
• Hard sudden movements
• Exercises with legs wide apart (such as side stretches on the reformer). These may place strain on the joint at the front of your pelvis.
• Lying flat as it can reduce the blood supply to you and your baby. If this occurs, you can feel dizzy or lightheaded.
• Inversions (where your feet are higher than your heart, with your hips up too)

Third trimester

In the third trimester focus on the following exercises:

• Breathing exercises
• Arm exercises
• Gentle stretches
• Pelvic floor exercises
• Supported back bends (such as over a bolster)
• Stability exercises for your lower back and pelvis
• Thigh strengthening exercises (not a deep squat in the last 4-6 weeks of pregnancy, as this may induce labour)

In the third trimester avoid the following:

• All second trimester items
• Exercises on one leg or with legs apart (lunges, splits)
• Deep squats during the last 4-6 weeks of pregnancy (increases pressure on the cervix and may induce labour)