How to work with prenatal clients

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Hello ladies!

I am beginning to teach both mat and reformer to a woman 6 weeks pregnant. With her last child she did not do any physical exercise because she was afraid of miscarrying. However, she would like to try Pilates once a week throughout this pregnancy. Can you give me some tips to use when working with her? Also, she hasn’t done Pilates for the last month and is worried that since she has been “out of practice”, starting up again will be like starting a new exercise program–which is not recommended in prenatal books. I assured her that this would not be a problem, but she would like the official word from the experts at PNWP.

Thanks so much!

Answer from Jean Leavenworth:

Hi there-
I am curious why she stopped exercising completely during her first pregnancy. Was she at risk for miscarrying? That is something to find out as it could still be an issue, and I would highly recommend that she is released by her physician to work with you during this pregnancy and that she is given permission to work with you through each trimester; the first trimester has the highest risk of miscarriage, so it is important that she has been cleared for exercise.

General contraindications during pregancy:

1.) no inverted exercises e.g. rollovers, short spine, etc

2.) no extreme stretching due to lax ligaments, especially side splits!

3.) Prone exercises may be uncomfortable due to breast tenderness and after the first trimester will need to be replaced by a quadruped position.
after 20 weeks, work in an inclined plane instead of supine (use arc barrel, spine supporter or similar device to keep upper body elevated)
be cautious about over-exertion or letting the body get over heated. Strengthening the core muscles will be very helpful to prevent excess lordosis during the pregnancy and it may help during the delivery process too.

4.) Pelvic floor exercises are great, but emphasis should also be placed on learning how to relax and release the pelvic floor too.

5.) side lying leg work is great to strengthen the abductors–use a pillow under belly as pregnancy progresses.

6.) arm work and upper body strength is important to prepare the new mom for carrying the baby around and all the other heavy baby stuff!

7.) Check for any changes in the diastus recti. If it separates during pregnancy, then extra care will need to be taken post-partum to avoid increasing separation of the rectus muscle. Flexion should be avoided or any other exercise that causes the diastus to increase. Strengthening the TA while keeping the spine neutral is optimal for healing the herniation.

Let me know if that makes sense!
Best wishes-
Jean