Prenatal Pilates: The Best Pregnancy Exercise

As a Women’s Health Physical Therapist and Movement Specialist, I have access to hundreds of exercise programs from Yoga to Cross Fit and Barre to Tabata.  When women ask me what is the best form of exercise to participate in during pregnancy, my answer is the same each and every time. 

Prenatal Pilates, hands down. 

If you’re not already a believer, or if you’re not really sure what Pilates even is, or if you’ve stumbled upon this blog and are just looking for a good debate, strap in and allow me to convince you!!!

Do You Really Need To Exercise During Pregnancy?

First of all, do you really even need to exercise in pregnancy?  Let’s face it, you’re already scheduling a bajillion appointments, you’re tired, is it even worth it? 

Yes, sweet friend, yes it is. 

According to the American College of Obstetricians and Gynecologists, the benefits of exercise include reducing back pain and easing constipation.  Regular exercise may decrease your risk of gestational diabetes, preeclampsia, and Cesarean delivery.  It promotes healthy weight gain and improves your overall fitness while strengthening your heart and blood vessels.  Exercise can also help you lose the baby weight after the baby is born. 

Still not convinced and thinking of coasting through the next 9 months? Well, think again, because it’s no longer just about you. 

New research shows that staying active during your pregnancy can set your baby up for a lifetime of health benefits.  In a study published in Medicine and Science in Sports and Exercise, infants of mothers who performed supervised, moderate-intensity exercise 3 days per week scored higher on stationary and locomotion skills as well as tests of neuromotor development than infants of mothers who did not exercise in pregnancy.  But these benefits may not just be limited to infancy. 

Other studies have shown that higher neuromotor skills in infants are linked with greater physical activity later in life.  So, if you haven’t been exposed to the pressures of mom guilt yet, allow me to be the first.  Kidding!  Honestly, I’m going to help you discover the best way to exercise in pregnancy, and it will be fun. 

Read on!

What is Pilates?

Pilates is a method of exercise designed by Joseph H. Pilates and has been around for over a hundred years.  Originally called Contrology, it is largely based on the principles of concentration, coordination, centering, breath, precision, and flow.  Did I lose you with those first two?  For those of you with wandering minds or two left feet, stick with me, there’s hope for you yet.  

Most gyms are set up to encourage you to work the big muscle groups that are already strong.  Making strong muscles even stronger (and usually bulkier) means the weaker ones remain weak and significant muscle imbalance can occur.  We are already imbalanced from too much time in sitting or on technology. 

Pilates works from within the body (and mind) first, encouraging you to find those tiny, whispering, stabilizing muscles that are so integral in allowing us to participate more fully in those big activities.  As Joseph Pilates said himself in 1945, fitness is about “the attainment and maintenance of a uniformly developed body with a sound mind fully capable of naturally, easily and satisfactorily performing our many and varied daily tasks with spontaneous zest and pleasure.” 

Zest and pleasure?  Where do I sign up?!

The Pilates Infomercial That Sparked Me Creating My Own Pilates Program

The first Pilates class I ever took was in my family room.  It was late at night and I just finished watching an infomercial for Marie Windsor Pilates DVDs.  Yes, DVDs.  The infomercial used words like sculpt, tone, and tighten.  And flatten and lean and firm and shrink.  I was instantly sold by the buzz words and cautiously optimistic about this new form of fitness. Plus, I was encouraged that I could test it out in the privacy of my own home. 

Now, just to clarify, these DVDs were teaching me mat-based Pilates exercises which, to this day, is my only form of Pilates practice.  Some Pilates classes use various types of Pilates equipment.  You see, when Joseph Pilates was incarcerated during World War I, he devised a system of exercises using bedsprings and other apparatus to train his fellow internees. 

Many Pilates studios will have Pilates exercise equipment including Reformers, chairs, barrels, towers, and the Cadillac.  The exercises I’m referring to in this blog though, are mat exercises.  Mat is where it’s at!

So fast forward from my Marie Windsor introduction to Pilates and I instantly fell in love with the exercise practice enough to take it a step farther and become certified to teach Pilates mat classes.  I taught for a couple of years as a side-gig to my day job as a Women’s Health Physical Therapist where I also incorporated many Pilates exercises with my own patients.  I loved the way the moves were low impact and focused on the important stabilizing muscles of the hips, pelvis, and core. 

When people hear the word “core” they instantly think of abdominals.  But your core is actually an internal canister with the diaphragm at the top, the abdominals out front, the pelvic floor at the bottom, and the lumbar multifidus muscles in the back.  Pilates is the only exercise practice I have found that so expertly gets them all, making it the perfect exercise for pregnancy.

Creating A Modified Pilates Program for Prenatal and Postpartum Women

When I got pregnant with my first child almost 16 years ago (!!!) I slowly began to realize that the regular Pilates exercises I was doing (the same ones I was using with my clients and patients) may not be the most appropriate for a pregnant or recently postpartum woman.  Why?  Here are the main reasons:

  1. There is quite a bit of head lifting which may cause an increase in the intra-abdominal pressure that might possibly be mismanaged.  In pregnancy, thanks in part to the extra progesterone and relaxin, certain areas might be more vulnerable to increased pressure like the linea alba (the connective tissue between your “6-pack” muscles) and pelvic floor muscles.
  2. One of the principles of Pilates is “flow”.  There is a certain dance-like quality to the program and a classic Pilates sequence has you quickly changing from supine to sitting back to supine to side-lying to all 4’s to supine, etc.  Due to the changes in a pregnant woman’s cardiovascular system, avoiding quick position changes may help regulate her blood pressure more.
  3. Certain Pilates moves are done in prone (lying on the stomach) which of course is not always possible or comfortable in pregnancy
  4. There are certain muscle groups needing more attention when you look at the event of birth.  For example, anterior hip stretching, hamstring stretching, and perhaps greater incorporation of pelvic floor activation AND relaxation with some of the sequences.
  5. I feel there needs to be a bit more upper body focus than what is offered in traditional Pilates mat exercises as a pregnant woman will soon be lifting a baby (and car seat and diaper bag and maybe even a toddler!)

In order to be sure I was modifying the Pilates sequences in a way that stayed true to the practice, I flew to New York and took certification classes to become a Prenatal and Postnatal Pilates Specialist through the Center for Women’s Fitness.  With some credentials in my back pocket and a baby in my belly, I was ready to put my new skills into practice.  I’ve been so very blessed to have been able to practice through two more of my own pregnancies and with thousands of other pregnant women over the last 10 years.

These moves along with almost every single Prenatal Pilates exercise I prescribe have the following benefits specific to the pregnant body:

  1. The exercises are low impact.
  2. They activate the important stabilizing muscles of the inner core to strengthen you from the inside out.
  3. They take your sacrum and pelvis through motions that will be used during vaginal birth
  4. There is an important and necessary focus on breathing to tap into the parasympathetic nervous system.
  5. They stretch what is typically tight in pregnancy while strengthening the muscles that often get overstretched and weak.
  6. They keep your pregnant pelvis symmetrical, and a symmetrical pelvis is a happy pelvis.
  7. There are endless opportunities to contract and relax the pelvic floor muscles (you’ll thank me later).

But here are real-life examples of what women say after class:

  • “I feel so much better after class than I did before class.”
  • “I feel like the baby has more space now.”
  • “My back doesn’t hurt anymore.”
  • “I think I contracted my pelvic floor the right way for the first time.”
  • “I’m so relaxed.”
  • “I’m finding muscles I didn’t even know I had.”
  • “I notice less urinary leakage since I started these exercises.”
  • “These movements seem to be helping me poop more regularly.”
  • “I’m more confident in my body’s ability to birth my baby.”
  • “I feel strong.”

For examples of specific Prenatal Pilates exercises I LOVE, check out my blog post here.  These mat exercises utilize a variety of positions including back-lying over an incline, side-lying, and short doses of quadrupled (or the “all 4’s” position).  Here’s the beauty of that last bit.  It’s absolutely essential that you expose your pregnant position to all of these positions so they are there for you in labor if you need them.  Being 41 weeks pregnant and trying to get on all 4’s for the first time usually doesn’t go so well.  But my clients are like, “I’ve been doing that for months, move over!”

The Possibilities With Prenatal Pilates Are Endless. 

I often get asked, “When is the best time to start a Prenatal Pilates practice?” 

I say as soon as possible. 

Some women struggle with morning sickness and fatigue during the first trimester, so sometimes it makes sense to wait until those symptoms resolve.  But the beauty of this exercise program is that with just a few calculated modifications and tweaks, you can start as soon as you’re pregnant and continue to benefit from the exercises for your entire pregnancy.  In fact, I encourage women to continue to exercise right up until the day they deliver if possible so that the stretching and strengthening will be there for them when they need it most!

Some women get nervous about introducing something new in pregnancy.  But according to ACOG, “If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity.

Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery. However, it is important to discuss exercise with your obstetrician or other members of your healthcare team during your early prenatal visits.”  

Other women are intimidated about starting Prenatal Pilates if they’ve never done regular Pilates before. Poppycock!  Whether you are a seasoned athlete or just starting out, Pilates is a practice that can be designed for just about everyone and modified for all sorts of orthopedic limitations.  Some pregnant women have trouble lying on their back.  No problem, almost every exercise can be adjusted so you can perform it in sitting or side-lying.  Some women stumble into my studio with lower back pain, sacroiliac joint dysfunction, or pubic bone pain.  More often than not, they leave feeling better and with some practical ideas of how to move should the pain return.

How Prenatal Pilates Can Help Women Build a Strong Pelvic Floor Foundation 

Another question, women want to know, is how often they should be doing the Prenatal Pilates exercises.  These movements are gentle enough to do every single day; however, life is busy and pregnancy is a time that can be riddled with more appointments and classes than usual while couples try to juggle work responsibilities and possibly other children.

I don’t like to add extra pressure and stress and obligations during this time so if you are managing to carve out 2-3 days per week to dedicate to these exercises, I think you are WINNING!

A Prenatal Pilates program also creates a foundation upon which you will build upon in your recovery from birth.  You are literally creating a muscle memory that you can tap into more automatically after the birth of your baby.  It’s easier to learn the moves in pregnancy than afterward when you may feel stretched out, disconnected to your body, and/or sore.  These very exercises can be adjusted once again on the flip side to accommodate the changes that occur in a postpartum body to make sure you are getting exactly what you need when you need it most. 

I don’t think the words “mommy” and “boot camp” belong in the same sentence together (more on that here), especially right after you have a baby, and would rather you once again turn inward to work on strengthening your body from the inside out first.  Most gyms encourage you to make the strong muscles even stronger which means the weaker muscles become even more disproportionately weaker.  I like to compare your postpartum body to a “fixer-upper’ project.  It’s not a complete teardown, but you definitely have to act like a general contractor and start with making sure the internal structures are sturdy before adding more intensity.  

While most studio instructors are capable of modifying a Pilates sequence to accommodate your pregnant body, I was extra careful to surround myself with experts when I was pregnant. 

After all, it’s not just about you anymore, there’s a baby in there going along for the ride each time you move your body. 

Not only am I a Prenatal Pilates Specialist but I have a Master of Science in Physical Therapy and have been specializing in Women’s Health for over 15 years.  I also used these very same exercises during all three of my pregnancies and couldn’t imagine heading into labor without them. 

Regardless of your situation, I have a program for you!  I have self-paced online classes you can access from any device and stop and start as often as you need.  I teach virtual group classes if you would benefit from connecting with other pregnant moms and hearing from guest speakers that can talk about giving birth in this current state of affairs. 

And I see clients privately, either in-person if you are local or virtually on Zoom.  Private sessions are best if you want a one-on-one, personalized program designed to specifically meet your needs and help you design a birth plan that aligns with your vision.  


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