Revolutionising Pregnancy Exercise: Prioritising Women's Long-Term Health
How often have you overheard another instructor advising a prenatal client on how to move safely during pregnancy? With all the emphasis in the media on protecting and nurturing expectant mothers, it raises the question: are we being overly cautious? In some cases, are we going too far by restricting movement, while in other cases we see pregnant women lifting heavy weights while doing dead lifts and squats? This article offers a fresh perspective—an opportunity to rethink our role as Pilates instructors working with pregnant clients.
There’s no question that pregnancy is the most profound change a woman’s body will have. Traditional exercise guidelines are almost all about the baby’s safety, but they overlook the long-term impact pregnancy has on the mother’s body. Over time, this can lead to a higher likelihood of hip and knee replacements, pelvic floor dysfunction, and chronic conditions like osteoporosis and osteoarthritis. However, these changes don’t have to be seen as negative. As a Pilates instructor, you are in a powerful position to make a positive difference to a women’s long-term health. By supporting mother and baby, you can help women not just survive pregnancy, but thrive—ensuring their bodies remain strong and healthy for years to come.
Think of it like a wedding—so much time and energy go into planning the big day, but often, little attention is given to nurturing the marriage afterward. We often treat pregnancy the same way. The focus tends to center on the baby, while the mother's well-being often takes a backseat. This mindset needs to shift. Mothers need ongoing support, not just during pregnancy but well into the postpartum period and the next stage of their lives. Let’s break it down.
The Facts Every Instructor Needs to Know:
Joint Health: A pregnant woman typically gains around 20% of her body weight, and this results in 100% more force going through her joints. This increase places significant strain on the hips, knees, ankles and feet. Strengthening and supporting these joints during pregnancy is key to minimizing long-term issues.
· Pelvic Floor Dysfunction: Up to 1 in 3 women in Australia experience continence issues, including prolapses and pelvic floor injuries. These changes are not always immediate; in many cases, they can surface later in life, particularly as women transition through menopause. Whether a woman has had a vaginal birth or not, her pelvic floor will be altered due to the strain it endures during pregnancy. This doesn’t necessarily mean it’s damaged, but it has changed. Unfortunately, pelvic health often doesn’t receive the attention it should in pregnancy and perinatal classes, leaving many women unaware of how to prevent, recognize, or manage these issues.
· Osteoporosis Risk: Women can experience osteopenia and osteoporosis during pregnancy and breastfeeding due to temporary bone density loss. While this is often temporary, it’s the perfect time to introduce discussions about bone health as women age. Ensuring women are doing double-leg weight-bearing exercises during pregnancy is crucial to support their bone health and reduce the risk of developing osteoporosis later in life.
· Ligament Stretching: During pregnancy, a woman’s ligaments and tendons are stretched to their maximum as the body adapts to accommodate a growing baby. Unlike muscles, ligaments and tendons have limited blood supply, meaning once they are overstretched, they don’t have the same capacity to rebound or repair. The goal is to support these structures during pregnancy, minimizing unnecessary strain and long-term changes. By carefully choosing exercises that avoid overstretching, you can help prevent lasting damage and weakness in these critical areas.
Emotional Impact of Injuries: Falls or fainting during pregnancy are not only physically dangerous but can have a lasting emotional impact. Women often feel guilt or anxiety after a fall, even if no physical harm is done. By prioritizing safety, you’re helping them stay confident in their fitness routine.
These facts underline why it’s crucial to focus not just on the baby, but also on the woman’s long-term health.
Guidelines for Pilates Instructors
You can start to use these tips in your classes today. Please note, these are just a taster of the full guidelines available in our workshop, which covers these topics in greater depth.
1. No supine exercises after 12 weeks
While some guidelines suggest stopping supine exercises at 28 weeks, we recommend switching to side-lying, seated, or standing exercises as early as 12 weeks. This helps reduce the risk of hypotension, which can cause dizziness, fainting, and falls. Every pregnancy is different, and we don’t know exactly who will be affected or when, but the theory behind 28 weeks is based on when the foetus gains more weight. However, second or third pregnancies can affect women differently. To avoid the risk of fainting, which can cause anxiety for the woman and the instructor, it’s best to make this adjustment earlier for safety.
2. Avoid one-legged weight-bearing exercises
Standing on one leg during pregnancy significantly increases the pressure on the pelvis. Pelvic pain is one of the most debilitating long-term issues that pregnant women can face, and the challenge is that we still don’t fully understand who will experience it. Because pelvic pain can be unpredictable, it’s essential to focus on balanced, supported movements that reduce strain on the pelvis. By minimizing one-legged, weight-bearing exercises, you can help lower the risk of pelvic pain and support the woman’s overall comfort and well-being.
3. No standing on equipment or unstable surfaces
With the added body weight and the shift in the centre of gravity during pregnancy, we strongly advise against having clients stand on equipment or unstable structures like balance boards. The risk of falls—for both the mother and the instructor—is too high. Pregnancy places extra strain on joints and balance, and these exercises increase the risk of injury. Keeping exercises grounded and safe is essential to ensure the well-being of the mother and her baby.
4. Communicate with your clients
Changing your teaching methods can be challenging, but clients are often much more receptive if you explain the reasons behind the changes. Tell your clients that these adjustments are designed to protect both their long-term health and their baby’s safety. Giving them full information and allowing them to consent to the changes empowers them to feel more confident in your guidance.
5. Be a Pelvic Health Advocate
You don’t need to teach pelvic floor exercises directly, but you can still make a huge difference by talking to your clients about pelvic health and encouraging them to see a pelvic floor specialist. Many women aren’t told about this in pregnancy classes, but by starting the conversation, you can help them avoid future issues like incontinence or pelvic organ prolapse.
Why These Changes Matter
Pregnancy and childbirth are life-changing events, and while we often focus on keeping the baby safe, it’s equally important to address the long-term health of the mother. These small changes can help women avoid issues like joint deterioration, pelvic pain, and emotional distress—all of which are preventable with the right support.
By incorporating these recommendations, you’re giving your clients the best chance at staying strong, healthy, and safe—not just during pregnancy but for the rest of their lives.
Pregnancy places immense stress on a woman’s body, and it’s our responsibility to help them navigate these changes safely. By understanding the long-term impact pregnancy has on joints, ligaments, and overall health, you can be a crucial ally in your clients' well-being. With the right support, you can ensure that your clients not only stay strong during pregnancy but that they also set themselves up for a healthier future.
Peta Titter is the Founder and CEO of the Women’s Health Education Network (WHEN)a not-for-profit organization. With 18 years of experience teaching Pilates and a background as a continence nurse, she is dedicated to improving women’s health.
The WHEN guidelines have been developed by a team of leading experts, including obstetricians, gynaecologists, physiotherapists, exercise physiologists, midwives, and continence specialists. These recommendations have been rigorously reviewed through our clinical governance committee.
To help Pilates instructors apply these enhanced guidelines, we’ve created an online Exercise in Pregnancy Workshop. This course is designed to provide you with the tools and knowledge to confidently integrate these changes into your practice. As a non-profit, all proceeds from the workshop go back into developing more educational resources for women’s health. In the workshop, we provide comprehensive guidance on everything discussed here—and more.
FAQs
1. What is WHEN’s vision?
Their vision is for every woman to wield the power to make informed health decisions and equip them with knowledge to confidently navigate their health journey.
2. Why is it important for Pilates instructors to focus on joint health during pregnancy?
Pregnancy causes significant strain on the joints, especially in the hips, knees, ankles, and feet, due to the body’s increased weight. Strengthening and supporting these joints during pregnancy is crucial to minimise long-term joint issues and support the mother’s long-term health.
3. What role does Pilates play in addressing pelvic floor dysfunction during and after pregnancy?
Pilates can help prevent and manage pelvic floor dysfunction, which affects many women during pregnancy and beyond. By providing focused exercises that support the pelvic floor, instructors can help women reduce the risk of prolapses and incontinence, ensuring better long-term pelvic health.