On All Fours - Pilates in Pregnancy and Beyond

TILDEN | Bar Rafaeli Prenatal Pilates
Photo: @barrefaeli via Instagram


Major League Baseball pitcher Nate Robertson said Pilates workouts between seasons made him more flexible and lean. NBA All-Star Jason Kidd likened the energy boost he gets from Pilates workouts to coffee. New England Patriots tight end Martellus Bennett said he uses Pilates to rebalance and activate muscle groups. 

From professional athletes to spandex-clad twenty-somethings to our parents, Pilates has achieved a broad reach. And it can be especially beneficial for pregnant women, according to David Woods, a senior Pilates trainer in San Francisco. Woods, a former professional ballerina who most notably danced for Ballet West in Salt Lake City, has trained clients in dance and fitness since 1985.

“In Pilates, you’ll learn how to push, what to push, and especially how to relax as you go through labor,” Woods said. 

Pelvic floor muscles stretch across the body from the pubic bone to the backbone. These muscles are strained during pregnancy and childbirth and are often weakened post-partum. Woods says strengthening pelvic floor muscles can help ease delivery and recovery.

Across clinical trials, data on the benefits of Pilates in improving pelvic floor functionality are mixed. One cross-sectional study found no difference in pelvic floor strength between younger women who practiced Pilates and those who were sedentary. A 2010 trial in 62 women showed similar improvements in pelvic muscle strength between groups randomized to either a Pilates exercise program or a pelvic-floor muscle training program.

However, plenty of studies report positive benefits specific to Pilates. A randomized trial of 40 healthy men and women showed statistically significant improvement in flexibility and lumbo-pelvic stability in the group who underwent Pilates-based training twice a week versus those who did not.

There is no real consensus with regard to the amount of exercise needed to improve pelvic floor muscle function, according to the Canadian Urological Association Journal (CUAJ). A review of current literature done by Marques et al suggests performing up to 200 reps of the all-powerful “Kegel” exercise a day.

Whether or not Pilates directly improves pelvic floor strength, Marques nicely concludes that increased Pilates (and yoga) activity can benefit overall strength and fitness of the body, “which intuitively would have a positive effect” on pelvic floor functionality.

To learn more about the specific role of Pilates in pregnancy, I sat down with Woods where he trains at Mercury Fitness Pilates studio in San Francisco.

The Interview

You’re a classically trained ballerina. How did you get involved in Pilates?

We had Pilates offered to us at Ballet West along with traditional training. It’s now commonly used in ballet training, but it wasn’t back then. We had reformer machines and other Pilates equipment in our locker rooms and were encouraged to do Pilates at other studios for extra help or when we felt burnt out.

What physiologic benefits are unique to Pilates?

There is a definite balance of physical, mental, and spiritual elements in Pilates. Sometimes as an athlete, you might train and the muscle part is easy. The mental part might be the most challenging and beneficial.

How can Pilates be helpful in pregnancy and beyond?

I’m a big fan of prenatal Pilates beginning even before you decide to get pregnant, particularly for the strength that it builds for the pelvic floor. We in Pilates talk about “core, core, core.” But core is really centered at your pelvis. Those connective muscles – the obliques, the rectus, and all the pelvic floor muscles - contribute to childbearing. 
Pilates will give you the strength and stability to endure, especially if you have to go through labor for a long time.

Can you start once you’re already pregnant?

There are a lot of Pilates trainers out there who say they will not take on clients who are pregnant who have never done Pilates before. I don’t do that. Anyone should be able to come in and start Pilates at any given time at any given age.

What exercises should women avoid when pregnant?

Every doctor, depending on his or her style and background, will give you different guidelines through pregnancy. Yes, I’ve heard that in the second trimester, you don't want to roll over, lie on your back, or do anything that might cut the baby’s blood supply. But for me, I go with what my clients feel okay doing.

What would you say are the greatest misconceptions about Pilates?

That it’s for women, yet it was created by a man [Joseph Pilates]. That it’s hours and hours of just stretching. That you’re not going to break a sweat. If you’re moving and your muscles are working, you’re naturally sweating.

Pilates, Bar Method, Soul Cycle. There are so many workouts today with strong fan followings. What differentiates Pilates from the rest of the pack?

In Pilates we are lengthening in addition to strengthening. Because of the machinery and the style of the exercises, it’s much more like a dance. You’re being stretched to elongate your muscles so you’re not bulking up. Pilates incorporates a true aesthetic look.

Pilates is also an activity that one can incorporate even as a basketball player or a runner. Try it out if you want to be longer, leaner, and have more agility. 

How many times a week should clients come to see benefits and how quickly can they expect to see them?

At least two times a week and you’ll start to see change. Three times a week and you’ll be able to see a complete transformation of your body over six weeks. There’s a six-week bell curve in Pilates training. It begins with the learning phase, moves to the accomplishment phase, and then starts to drift off. I have to keep changing things around and mixing it up for my clients.

Can you give us two key exercises we can do at home that are particularly effective for pregnancy and post-partum recovery?

Get on all fours! Do pelvic tilts with leg and arm extensions, which will also work your balance. It’s still okay to do planks in your first and second trimester and they’re very beneficial. Keeping yourself on a downward plank or all fours pitch for 20 minutes a day can help to turn a breech baby. It can also help to drop the position of your baby for your comfort. Work that natural gravity position. Using your transverse abdominals by doing hip lifts on your side from a plank position will help you to carry the baby weight more easily.


Mercury Fitness
2904 Laguna Street, San Francisco 94123
(415) 567-9009
About David Woods

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