Pilates and Pregnancy

Pregnancy is a time of great change within a woman's body, however in a healthy uncomplicated pregnancy, exercise can continue to be safe and is generally recommended for most women. Pilates can be a very beneficial form of exercise during pregnancy if you are conscious of the precautions to take and are knowledgeable about the effects that exercise may have on you and your developing baby. All pregnant women should have a medical clearance before commencing Pilates.  

In most pregnancies, regular moderate intensity physical activity is encouraged, however some important considerations when exercising during pregnancy are detailed below.

HOW CAN PILATES HELP DURING PREGNANCY?

As your baby grows, your posture will change.  Alterations in your posture may contribute to certain muscles tightening and shortening and others lengthening and weakening.

Pregnancy hormones cause a 'softening' of the ligaments, potentially leading to reduced joint support. This, along with the extra pressure on the pelvic floor muscles and abdominal muscles as the baby grows, may result in less support of the lower back and pelvis. It is recommended to avoid high impact, jolting exercises. 

Commonly the central vertical abdominal muscles stretch and separate at their midline. This is known as a rectus abdominis diastasis. While it is important to maintain abdominal muscle strength during pregnancy, correct exercise technique is essential, as performing conventional sit-up exercises or double leg lifting exercises may actually worsen this separation.

During pregnancy, extra strain on the pelvic floor muscles may mean they don't work quite as well as they should, possibly resulting in impairments in bladder and bowel function such as incontinence and reduced support of the pelvic organs, which may manifest as a pelvic organ prolapse

Pilates can help to maintain the strength of the pelvic floor muscles and abdominal muscles and minimize the adverse effects of the postural changes that result.  As these movements are very precise, closely supervised instruction is important, since incorrect activation will not result in the desired outcome, or worse, may aggravate an existing problem or cause an injury.  For this reason learning Pilates from a book or DVD is generally not recommended, especially when pregnant, as certain modifications will need to be made to many of the exercises. 

IMPORTANT CONSIDERATIONS WHEN EXERCISING DURING PREGNANCY

  • Avoid overheating.  Your growing baby does not have the same ability to dissipate heat as you do.  Consequently, if you become overheated when exercising, your baby can be put at risk.  This is particularly true during the first trimester, when the most important growth, cell reproduction and formation are occurring.  To avoid overheating:
    • Give yourself breaks during your Pilates session to rest and cool off,
    • Stay well hydrated.  Ensure you bring a water bottle and drink plenty of water before, during and after your session even if you do not feel thirsty,
    • Don't use sweating as an indicator of how hot you may be getting, as your core temperature may rise disproportionately to the amount of perspiration,
    • Avoid exercising in hot, humid conditions,
    • Wear light-weight, loose fitting clothes - cotton is best,
    • Avoid saunas and steam baths at all times during pregnancy.
  • Avoid high intensity exercise.  As your pregnancy progresses, your increased weight will add to the overload effect of exercise and you may need to switch to lighter resistance or easier versions of exercises you currently perform.  A good guide is that you should be able to comfortably carry on a conversation throughout the session – referred to as the 'talk test'.  Make sure that you always exercise at your own pace and avoid holding your breath.
  • When exercising, avoid rapid changes of position and stopping suddenly.  Keep the feet moving to help the circulation and prevent leg cramps and faintness.
  • With exercise pregnant women sometimes experience low blood sugar levels, resulting in light-headedness or faintness.  Eat some form of carbohydrate before and after exercising to help keep blood sugar levels from fluctuating too much.
  • Many women find that they need to limit the amount of exercise performed lying on their back as the pregnancy progresses. Exercising on your back (as when doing abdominal exercises) could cause a reduction in blood flow to your heart and head, causing you to feel faint and light headed.  More importantly, the blood flow to the placenta and baby can decrease.  If you do feel at all dizzy or light-headed when lying on your back, turn onto your side and rest.
  • Modify your abdominal work. If a rectus abdominis diastasis is present, abdominal muscle exercises will need to be modified.  Throughout your pregnancy your abdomen should be monitored for any signs of a diastasis, and if present, regular checks can to assess the extent of separation.
  • Perform pelvic floor muscle exercises. Strengthening these muscles will help to support your trunk and pelvis and also help to prevent impairments in bladder and bowel function such as incontinence and reduced support of the pelvic organs, which may manifest as a pelvic organ prolapse.  When performing these exercises you should feel a squeeze and lift movement, and then a definite relaxation post-contraction.  Our Fact Sheet on Pelvic Floor Muscles discusses this in greater detail, including the importance of  seeking advice from a Women’s Health and Continence Physiotherapist If you are unable to feel the correct muscle action, including the ability to relax post-contraction, or are experiencing any other signs and symptoms of pelvic floor muscle dysfunction.
  • Wear a good supportive maternity bra.
  • Stretch gently.  Pregnancy hormones contribute to increased joint laxity, which may make you more susceptible to injury.  Be cautious and gentle with your stretching.

STOP EXERCISING AND SEEK MEDICAL ADVICE IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • Vaginal bleeding or leakage of amniotic fluid,
  • Contractions or a decrease in the movements of your baby,
  • Chest pain, dizziness, faintness or palpitations,
  • Blurred vision, disorientation, or severe or continuous headaches,
  • New or persistent nausea or vomiting,
  • Excessive fatigue or muscle weakness,
  • Calf pain or swelling,
  • Shortness of breath before exertion, or excessive shortness of breath
  • Sudden swelling of hands, ankles or face

Reference:

American College of Obstetricians and Gynecologists (2015) Physical Activity and Exercise During Pregnancy and the Postpartum Period.  Committee on Obstetric Practice, Number 650