Prenatal Pilates: An Instructor Do-and-Don’t List

by Leslie Braverman on July 19, 2015

The American Congress of Obstetricians and Gynecologists (ACOG) and IDEA Health & Fitness—the world’s largest association for health and fitness professionals—encourage regular exercise during pregnancy to:

  • improve energy
  • strengthen muscles
  • help control weight
  • build and maintain strong bones
  • improve sleep
  • improve mood, body image and reduce postpartum depression

Prenatal Pilates exercise on Pilates Reformer

Certified, experienced Pilates professionals—specifically, Pacific NW Pilates instructors—are poised to teach moms-to-be, following exercise guidelines offered by both organizations. It is important that Pilates teachers are familiar with how a woman’s body changes during pregnancy, and how to safely modify exercises for expectant clients.

Prenatal Pilates Exercise Guidelines for Instructors


Labor, delivery and early motherhood is highly physical and demanding. The average delivery lasts 12 hours—with some rest periods—and requires strength and endurance. At home, a new mother needs upper body strength to carry her infant, lift awkward carriers and push strollers. Preparing intentionally for pregnancy and the physical challenges of caring for a newborn may minimize the risk of injury during recovery.

Get ready: Don’t underestimate the value of training for pregnancy.

  1. Work on core and upper body strength and endurance
  2. Improve mobility and strength of adductors, hamstrings and gluteals

Pre-pregnancy is an excellent time to work on mechanics and strength of the arms, shoulder and scapulae as shown here in Side Arm work and Side Twist Sitting:

Side arm work on Pilates Reformer is an effective prenatal exercise     Side arm stretch on Pilates Reformer is an effective prenatal exercise


The first trimester (0 – 12 weeks)

During the first trimester, hormonal changes—increases in progesterone, estrogen and relaxin—make collagen more pliable. A surge of hormones prepares the mother’s pelvis for delivery; those hormones can also make joints and ligaments lax and unstable.


  • Obtain permission to exercise from the client’s physician
  • Focus on good core stability
  • Pay attention to excellent posture

Don’t hold stretches.

Prenatal Pilates exercise using stability ball

An inclined position on the stability ball is a great place to work on the gentle engagement of pelvic floor and transversus abdominis in a neutral position.

The second trimester (13 – 26 weeks)

During the second trimester the pelvis becomes more mobile and the center of gravity is altered. The growing uterus may compress the vena cava in supine (lying on back) positions.


  • Work in neutral anatomical alignment
  • Focus on shoulder stability
  • Encourage natural breathing patterns

Don’t use supine, prone or inverted exercises.

PNWP Last Session Lou & Ryan, etc-88webMoms-to-be can strengthen their legs in an upright position on the Split Pedal Stability Chair.

The third trimester (27 – 40 weeks)

During the final phase of pregnancy, the mother may become short of breath when exercising. Ankle swelling (edema) may occur.


  • Keep ankles mobile to help with circulation
  • Change positions frequently
  • Incorporate squats to prepare for pregnancy

Don’t use supine, prone or inverted exercises.

The benefits of prenatal Pilates exercises are many. The best result of careful, professionally supervised exercise during pregnancy is feeling confident and strong to really enjoy that precious new baby.  

PNWP Instructor Trainer Erica Loder is a fantastic example of a prenatal Pilates exercise.

Instructors, sharpen your skills with two 2018 workshops at PNWP: STOTT PILATES Prenatal Matwork with Stability Ball & Flexband and STOTT PILATES Post Natal Pilates.

Pacific NW Pilates is studio, school and fitness family under one roof. Click to learn more about our education courses and workshops, private studio sessions and group classes. Or call Brette for details: (503) 292-4409.

{ 4 comments… read them below or add one }

Lorwina Yu Tamondong June 24, 2016 at 6:47 pm

I’d like to ask about one of my prenatal client. She is strong, she even (most of the time)add spring when we’re doing arm work on the reformer, my concern is how would i address (again)that pranatal is not a time for fitness, especially not same intensity that she use to do before pregnancy. And my biggest concern is the alignment, stabilizations and proper positioning are really an eye sore. I am not her only instructor but she attends on other prenatal class, she told me she gets bored on our sessions. But how can i make it challenging to her part, especially her level of strength if the basic principle is absent. I hope guys you can make a blog about this topic, so that we, instructors would be reminded that we have ro be careful on the exercises that we give to our clients. I know this is a little out of the topic above, but still about prenatal sessions.
Thank you for taking time to read this.


Leslie Braverman August 21, 2016 at 10:05 am

Hello Lorwina,
This is a very good question. Indeed you need to be safe with your pregnant client, but still keep her fit and keep her sessions enjoyable.

What is contraindicated during pregnancy is excessive strain on the pelvic floor, exercising with the heart rate above 140 beats per minute, and focusing on strengthening the abdominals in a shortened position. You should also avoid repeated strong contractions of the hip adductors in exercises like side splits. There are more precautions if she is having sacroiliac joint problems or if there is any risk to the pregnancy.

Your goals are to prevent injury, maintain mobility, and to develop strength and endurance of the gluteals, core, mid back, and shoulders. It is not a problem to challenge arm and leg strength, as long as she is not bearing down on the pelvic floor excessively, and she can continue to breathe without bearing down too much. You can explain that excessive bearing down can lead to pelvic floor issues and incontinence after pregnancy.

You can use all positions except for prone and flat supine. Quadruped, side lying, sitting and standing positions should be integrated into each session. You can also integrate the supported recline position if you have a wedge, barrels, or spine supporter. Great exercises that can be challenging and productive include:

foot work seated on the chair
mid back series on the Cadillac with one or two feet on the mat
front and back rowing
quadruped swimming preps
one arm prep, hand on floor on chair
standing arm work on cadillac or V2Max- including punches, offering, salute, and trapezius strengthener
side arm series
side leg lift series
knee stretches in neutral spine (depending on the side of her belly)
round back and flat back (small range of motion) on the reformer or ladder barrel
standing push ups on the ladder barrel

These exercises can help to improve your clients posture, strength, endurance, and will help prepare her for labor.

Thank you for contacting us with this question.
All the best to you

Melanie, Leslie and the PNWP team


Michelle March 8, 2017 at 3:36 pm


Can my client in her 2nd trimester do leg circles on the reformer, wedged up. Is that safe?


Leslie Braverman March 13, 2017 at 5:27 pm

Hello Michelle,

We received your email to our Prenatal Pilates post. Thanks for your question.

During the 2nd Trimester (13-26 weeks) the greatest changes in pelvic mobility and instability occur during the 20-27 week period. It’s recommended that students exercise in a neutral position, avoid exercises that incorporate long levered movement and open kinetic chain activity.

Since leg circles on the reformer require an abundance of stability—legs are moving in a large range of motion in opposing directions, you probably want to avoid doing this exercise with your client at this stage. Of course, everyone is different, but generally speaking modified options should be considered—the joints are becoming more lax and could result in injury or weakness of the soft tissue around the hips (ligaments).

Feel free to write back if you have other questions or concerns. In addition, please let us know if you you’d like to be included in our education newsletters where you’ll find out more about upcoming education, tips and advice.

Leslie, Melanie and the PNWP team


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