Health
Pilates in pregnancy and after birth: is it safe, and what to watch for?
In short: In an uncomplicated pregnancy, regular physical activity is recommended: international guidelines advise at least 150 minutes of moderate activity a week. Meta-analyses report that pilates in pregnancy is associated with shorter labour and less labour pain. Always get your doctor's approval first, and after birth start again only after your check-up, beginning with pelvic floor work.
Pregnancy is a time when many women think more carefully about exercise. "Can I do pilates?", "Which movements should I avoid?" and "When can I start after the birth?" are the questions we hear most. Here we summarise international guidelines and research.
Please note: get approval from your obstetrician before exercising during pregnancy or after birth. This article is for information and does not replace personal medical advice.
What do guidelines say about exercise in pregnancy?
The 2019 Canadian guideline on physical activity in pregnancy and the World Health Organization's 2020 guidelines recommend regular physical activity for women with uncomplicated pregnancies:
- At least 150 minutes a week of moderate activity, spread over at least 3 days.
- A combination of aerobic and muscle-strengthening exercise.
- Pelvic floor muscle training, which can be done daily to reduce the risk of urinary incontinence.
- Changing position if lying on your back makes you light-headed, nauseous or unwell.
The Canadian guideline notes that the benefits of exercise in pregnancy are moderate and no clear harms were found. Exercise is not advised in some situations, though, and your doctor makes that call.
Pilates in pregnancy: the research
Length of labour
A 2024 meta-analysis of 11 studies reported a shorter active phase and shorter total labour in women who did pilates during pregnancy.
Pain and the baby
Another meta-analysis published in 2025 (11 studies, 538 participants) found pilates shortened labour, reduced labour pain and improved the baby's 1-minute APGAR score, with no clear effect on weight or mode of delivery.
Some studies had an unclear risk of bias; the results are encouraging but not definitive.
What do we watch for in pregnancy pilates?
- Long periods lying on your back: especially later in pregnancy, we offer side-lying, seated or inclined alternatives.
- Pressure on the abdomen and intense abdominal crunches: we leave out crunch-type movements and focus on breathing and the deep abdominal muscles.
- Balance: your centre of gravity changes, so we avoid movements with a risk of falling.
- Intensity: we work at a pace where you can talk and take care not to overheat.
Stop exercising and contact your doctor if you have: vaginal bleeding, leaking fluid, regular painful contractions, chest pain, calf pain or swelling, dizziness or feeling faint, or breathlessness before exercise.
After birth: when and how?
When you return to exercise depends on the type of birth and how you are recovering; decide after your medical check-up. A 2025 meta-analysis of 65 studies found pelvic floor muscle training in the first year after birth reduced the odds of urinary incontinence by about 37%. That is why starting with the pelvic floor and breathing makes sense.
If you have a separation of the abdominal muscles (diastasis recti), tell your instructor; we choose movements accordingly.
Pregnancy and postnatal pilates at Studio 4
We work with pregnant and postnatal students in private classes, building the programme around your week, your energy and your doctor's advice. If you are new to pilates, see our first class guide too.
Frequently asked
Can I start pilates for the first time while pregnant?
Yes, if your doctor approves; start at a lower intensity with an instructor. Guidelines advise starting gradually if you were not exercising regularly before.
Can the reformer be used in pregnancy?
Yes, with suitable positions. Because the springs can support movement, many exercises can be adapted; we limit time spent lying on your back.
How many weeks after birth can I start pilates?
It depends on the type of birth and your recovery. We recommend starting with pelvic floor and breathing work after your medical check-up.
Sources
- Mottola MF et al. 2019 Canadian guideline for physical activity throughout pregnancy. BJSM, 2018
- Bull FC et al. WHO 2020 guidelines on physical activity and sedentary behaviour. BJSM, 2020
- Haseli A et al. Optimizing labor duration with pilates: a systematic review and meta-analysis. BMC Pregnancy Childbirth, 2024
- Li Y et al. Pilates exercise in pregnancy: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil, 2025
- Beamish NF et al. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis. BJSM, 2025