The challenge with immediate bookings
The boom of fitness apps that allow clients to book in last minute is great to fill remaining spots in classes. The variety of studios and classes to choose from appeals to many but the question is, are they suitable for special needs or pregnant clients? What about the uncomplicated pregnant client? Let’s talk about pregnant clients in this example. If you ask Hannah and I, our answer would be no. These clients need to join a pregnancy-specific class. If you don’t offer a pregnancy-specific class, perhaps it’s time to, while ensuring the best practice for your pregnant clients.
The issue we see out there in the Pilates landscape is that many studios allow these clients to join regular classes. In our view modifications are not always suitable for the pregnant client. During some recent antenatal women’s health screenings, clients have reported situations they have encountered in a general Pilates reformer class which are alarming. Pilates balls and the reformer box have been used to ‘prop’ a pregnant client up in lieu of a supportive pregnancy wedge. In other instances, ‘pregnancy modified’ variations have been prescribed which are still not appropriate or safe for the second and third trimesters, such as being corrected for abdominal doming in performing arms in straps with the legs in table-top (without a chest lift).
It's not as simple as just modifying exercises. It’s important that we're not incidentally performing abdominally loaded exercises without realising or intending to do it – like the arms in straps example above. You need to be well versed in supporting pregnant clients to avoid risk to them and also to the teacher. In these situations, the studio may be liable for not providing adequate or appropriate equipment, however, ultimately the teacher has a responsibility to be educated in suitable women’s health pregnancy exercises and to provide the appropriate duty of care.
We offer pregnancy-specific classes because we understand that every pregnancy journey is unique and that each individual will experience their own significant physiological, hormonal and emotional changes. While pregnancy is often accompanied by feelings of joy, optimism and hope for the future, it can also be a challenging time for women, impacting their mental health. A Pregnancy pilates class allows the teacher to create a supportive environment, providing education while programming the exercises to be specific, safe and effective.
This doesn’t mean that we think we know better than most pilates teachers and studio owners out there, rather we are suggesting that there are better ways to support our pregnant clients, than just modifying classes to accommodate them.
Exercise in pregnancy has been shown to reduce the risk of developing gestational diabetes, preeclampsia, gestational hypertension and prenatal depressive symptoms (Margie Davenport, PhD), so the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) advise that we should encourage all pregnant women to participate in regular exercise …. in other words, Pilates is ideal!
In our experience, clients are often drawn to a Pilates class for an intermediate to advanced level workout, focussing on building core and abdominal muscle strength to maintain a well-toned physique.
Sports Medicine Australia (SMA) lists some exercises to avoid during pregnancy including performing exercise in the supine position, loading of the rectus abdominis muscles or breath holding causing an increase in intra-abdominal pressure, where a high level of balance is required or there is an increased risk of falling. As most of you know, these positions and exercises, for example, would be commonly used and challenged in a general pilates class and are therefore unsuitable during pregnancy. It would be an even greater challenge for the teacher to be able to modify this type of class if a pregnant client turned up.
Pregnant clients should also be advised to recognise the signs of fatigue where balance and coordination might be compromised, to limit end-range positioning and to take care with upper limb weight bearing with the peaking of the Relaxin hormone at the end of the first trimester. We ask our clients to disclose their pregnancy from 12 weeks gestation and it is also clearly stated in our studio policy that we do not allow pregnant ladies to attend our general classes beyond 16 weeks.
I’ve had a client show up pregnant to a 6am class after a four month break, booking in last minute through a fitness app, so I had to turn her away. It is my duty of care. It wasn’t easy but I just can’t risk it. We’ve asked a certain app company to put a disclaimer on our classes to clearly identify that our signature / general pilates classes are not suitable for pregnancy.
Turning pregnant clients away from a general pilates class is an ethical decision, because it is not the best practice or appropriate for them. Offering specific classes for different populations may initially run at a cost to a pilates studio, however it does provide a business opportunity to expand services while also building a community. We offer Pregnancy-specific classes to provide this necessary service, rather than modifying exercises which may then also be restrictive for a general class. This has also proved to be an opportunity to offer and grow our Mums and Bubs clientele.
Another positive of a Pregnancy specific exercise class is that it’s a great opportunity to educate and empower mums-to-be about the benefits of ante-natal exercise, to safely maintain strength and fitness for optimum antenatal health and to prepare for an active birth. The class can focus on postural, shoulder, hip and pelvic girdle-specific exercises including mobility, pelvic floor muscle education, strength and endurance, relaxation and avoiding lying supine with the use of a pregnancy wedge from the 16th week of gestation (or second trimester).
The exercises we prescribe should minimise abdominal muscle loading and can be performed at a moderate level of intensity* (12-14 on the BORG RPE scale) as observed by the class teacher and clients should also be taught to self-monitor.
A Pilates class may not be suitable for any individual with medical, physical or movement restrictions or contraindications, so it is advisable that each studio have a screening** procedure in place to guide clients toward a studio-based offering in this case.
Pregnant clients need to understand that a pregnancy class is most appropriate for them. Even for clients with an uncomplicated and seemingly “good” pregnancy. It’s our role to educate the client which is why your training matters. What we see is that the level of pilates teacher education required for employment in certain studios and chains varies significantly. It’s important that you obtain in-depth education if you plan to teach pregnant clients and have the appropriate equipment available to use. If you are unsure, ask your mentor, a colleague or a friend. Having this training will empower you as an Instructor and it also enables you to feel comfortable knowing when to say no to a client too.
Allowing a pregnant client to attend a general pilates class is not only not o.k. but it’s unsafe. Ensure you have undertaken a minimum level of training, use appropriate supportive props or equipment, understand the differences in pregnancy programming, have clear policies in place to protect your staff and a clear disclaimer for your clients so they can have confidence that you are looking after them in the best way possible.
* RANZCOG Exercise in Pregnancy Guidelines – safe for a pregnancy class situation with clients of varying fitness levels.
** Sports Medicine Australia (SMA) also advises screening for certain conditions affecting mother and baby specific to pregnancy. Supervision under the care of a women’s health physiotherapist is recommended for these women and it may be appropriate for them to exercise in a studio setting.
Audrey – I am an APA Women’s and Pelvic Health physiotherapist, a Pilates teacher for 25 years, a member of the Polestar Pilates faculty with a special interest in treating the hip and pelvic girdle. With two adult sons of my own and having experienced first-hand the benefits of pilates as my antenatal exercise, I enjoy working with women through pregnancy and in the post-partum period. I own Performance Pilates & Physiotherapy in Leederville, WA and a co-owner of Pilates on Angelo in South Perth.
Hannah – I am a Diploma qualified Pilates instructor, a member of the Polestar Pilates faculty and have undertaken further training in Ante & Post natal Pilates. I have a special interest in functional re-training and movement optimisation. I enjoy working with clients of all levels, ages and abilities as well as ante and post natal women, supporting them through their journey into motherhood. I am a co-owner of Pilates on Angelo in South Perth, WA.