Pregnancy Pilates: key things you need to know if you are pregnant

Pregnancy Pilates is becoming increasingly popular all across the world. This article discusses in detail everything a pregnant woman needs to know about the safe practice of Pilates during pregnancy. This also provides useful links to the guidance from recognised relevant medical organisations on exercise during pregnancy.

What is Pilates?

Pilates is of a group of exercises (‘low impact’) and breathing techniques which aim to improve the strength of the abdominal, pelvic floor and back muscles to develop a stable central core (trunk muscles).

The six basic principles (Ref 1) of the practice of Pilates are as follows:

– Concentration

– Control

– Precision

– Flow

– Breathing

– Centre of force or Centering

The ‘centre of force’ or ‘Centering’ or Core is the primary focus of the Pilates and is this includes flexor and extensor muscles of the spine and hip and the pelvic floor muscles. Joseph Pilates described this as the ‘Powerhouse of the body’.

The aim of the Pilates is to develop a stable and strong central core first. Pilates is a known practice to help to strengthen the core trunk muscles. (Ref 2 )

Subsequently, the instructor introduces more difficult/ powerful movements and exercises of the extremities to avoid strain to the body.

One could do Pilates exercises either on a mat or with the help of special equipment, which could be used to support a specific posture or create resistance to strengthen the muscles, depending on the individual needs and exercise plan.

Usually, a standard Pilate training regime consists of both mat and equipment-based exercises. (Ref 3)

Pilate is now a quite popular form of exercises and could help in the following:

1. Posture improvement

2. Better balance, body strength and muscle tone

3. The mobility of joints and flexibility

4. Stress relief and wellbeing

Myth and reality:

Many people believe that a stable central core is synonymous with toned ‘abs’ (abdominal muscles) or a ‘six-pack’. It is important to remember that in reality, these abdominal muscles contribute very little to the core strength of the trunk for a good posture and balance.

The important contributors to the core strength are the back and pelvic floor and specific breathing techniques.

Strengthening of these muscles and appropriate breathing techniques are the key principles of Pilates.

Is Pregnancy Pilates safe during the first, second and third trimester?

There is very limited research on the pregnancy pilates. However, due to the gentle nature of the exercises, pilates during pregnancy is usually considered safe both at the early (first trimester) and late stages (second and third trimesters) of pregnancy and post-childbirth period.

The injury from prenatal pilates exercises is rare due to the low-impact nature of the Pilates training.

However, it is always advisable that Pregnancy Pilates should be done under supervision and guidance of a Pilate Instructor/ Trainer with experience of prenatal pilates training. If someone is already doing Pilates before pregnancy, she should inform the Trainer once she is pregnant as necessary modifications of the exercise regime could be necessary.

Please find what a Midwife and Prenatal Pilate Instructor, Nikki Williams-Quamina has to say.

What precautions do I need to take for prenatal Pilates?

During the pregnancy Pilates sessions (and other forms of exercises during pregnancy), it is advisable to wear appropriate supportive bra and clothing which are comfortable and safe and also drink plenty of fluid to avoid dehydration.

It is also advisable to avoid the following during pregnancy:

1. ‘Hot’ Pilates (Ref 4)

2. Exercises on the supine position (lying flat on the back): you should avoid this position after the first trimester (first twelve weeks) to avoid obstruction to the blood flow to the baby.

This is one of the reasons why Pilates is becoming an increasingly popular form of exercise during pregnancy as many of them can be done lying on the sides and sitting positions. (Ref 3) 

3. Over-stretching of muscles/ joints and over-exhaustion.

I have a medical condition. Can I do Pilates during pregnancy?

If she has any medical condition or develops pregnancy complication, she must get a medical advice from a doctor before continuing Pilates (also applicable to any exercise during pregnancy).

I have never done Pilates in the past. Can I start Pilates for the first time during pregnancy?

Of course, you can do so. However please join pregnancy specific Pilates class or get a personal trainer who is experienced and trained in Pregnancy Pilates.

What are the benefits of Pilates during the pregnancy and perinatal period?

It is generally thought that Pilates helps women to adapt better to the changes of pregnancy by strengthening and stabilising pelvic floor, back, and abdominal muscles.

Recent studies have indicated that Pregnancy Pilates is an effective way to reduce aches and pain during pregnancy. 

Studies also have shown that a well-structured prenatal Pilates programme also have shown to result in ‘significant improvements in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention.’

Although such results are encouraging, we have to remember that these findings are based on small studies. Further research is needed to better understand and ascertain the benefits of Pilates during pregnancy and post-childbirth period.

How soon can I start postnatal pilates after the childbirth?

Mothers are encouraged to commence Pilates after childbirth, as soon as practicable to ensure ongoing benefits of physical and mental wellbeing.


Pregnancy Pilates


How is Pilates different from yoga?

Both the Pregnancy Pilates and pregnancy yoga are safe and good forms of exercises during the pregnancy and post-childbirth period and choosing one over the other is usually a personal choice. It is important to carry out both practices correctly with appropriate instruction, supervision, and training. Some people even combine them both to stay active during pregnancy and post-childbirth period.

They are similar in many different ways including the involvement of specific position and postures to improve balance, strength, and stability of the body for physical and mental wellbeing.

Both are low-impact (no jumping involved) types of exercises.

Some of the differences are:

1. The origin:

Yoga is often described as a way of life and it originated almost 5000 years ago in India as a philosophy to connect the body, mind, and spirit and to have better understanding and awareness of the inner self.

Pilates was created by Joseph Pilates in early 20th Century with the aim of rehabilitation (from physical injuries) of World War 1 soldiers. The primary aim of the Pilates is stabilising the inner core muscle strength.

2. The main focus:

Yoga often involves meditation and quiet contemplation. Some people want to learn and practice yoga with a view to relieving stress. Therefore, a large part of the yoga focuses on the mind.

Pilates, on the other hand, aims to improve the muscle tone and strength by exercises and breathing techniques Although Pilates also helps to improve emotional and mental wellbeing, this is not it’s primary goal.

3. Types of movement and joint flexibility:

Yoga mainly focuses on stretching of the body and holding this in a static posture to improve the flexibility of the different joints.

Pilates is more dynamic and the focus is mainly on the strengthening of the central core (trunk muscles). Although Pilates helps to improve joint flexibility but this is not the primary focus.

4. Breathing techniques:

Yoga focuses on breathing based on the stomach (abdominal) muscles, whereas, Pilates training involves lateral chest breathing techniques aiming to improve the core strength

5. Need for equipment:

Yoga is a mat-based exercise and does not involve equipment.

Pilates training usually combines both mat and equipment-based exercises.


Pregnancy Pilates is usually considered a safe form of exercise during pregnancy and post-childbirth period but it is recommended that it is done under the supervision and guidance of a Pilates instructor who is experienced and appropriately trained in Pilates during pregnancy and perinatal period. The Pilate instructor should be informed by the woman when she gets pregnant so that appropriate changes are made depending on the stage of pregnancy. 

If you have a medical condition and planning to commence Pilates for the first time or develop any pregnancy or birth complication, then medical advice must be sought from your Obstetrician, GP or another healthcare provider.


Please find further information on exercise during pregnancy:

1. The American College of Obstetricians and Gynaecologists (USA)

2. The Royal College of Obstetricians and Gynaecologists (UK)

3. The UK Department of Health information and infographic (UK)



1. Muscolino JE, Cipriani S. Pilates and the “powerhouse”—I. J Bodyw Mov Ther. 2004;8: 15–24 

2. Finatto P, Silva ESD, Okamura AB, Almada BP, Oliveira HB, Peyré-Tartaruga LA (2018) Pilates training improves 5-km run performance by changing metabolic cost and muscle activity in trained runners.

3. Pilates and pregnancy. Balogh A. RCM Midwives (2005) 

4. Exercise during pregnancy: The American College of Obstetricians and Gynaecologists (July 2017)

5. Pilates and pregnancy. Tommy’s


Photo credit

Jessica Monte via