Is Pilates safe during pregnancy?
Yes — Pilates is one of the most recommended forms of exercise during pregnancy. The NHS specifically highlights pelvic floor exercises and core strengthening as beneficial, and Pilates provides both in a controlled, low-impact format. Many NHS trusts and midwifery services actively recommend antenatal Pilates as part of a healthy pregnancy.
Unlike high-impact exercise, Pilates is gentle on the joints, adaptable at every stage of pregnancy, and can be continued right up to the final weeks in a modified form. If you have never done Pilates before, pregnancy is an excellent time to start — many studios offer dedicated antenatal Pilates classes for all levels.
Why Pilates is particularly well-suited to pregnancy
Pilates focuses on the deep stabilising muscles of the trunk, pelvic floor, and spine — precisely the muscles that are put under the most strain during pregnancy and labour.
Pelvic floor strength is one of the most significant benefits. The pelvic floor supports the increasing weight of the uterus throughout pregnancy and is under considerable stress during labour. Pilates exercises that activate and train the pelvic floor help maintain continence, reduce pelvic girdle pain, and support recovery after birth.
Core stability is equally important. As the bump grows, the centre of gravity shifts forward and the lower back is placed under increasing load. Strong deep abdominal and back muscles reduce the risk of lower back pain — one of the most common complaints in pregnancy — and help the body adapt to the changing load without strain.
Posture also benefits. Pregnancy naturally shifts posture as the bump pulls the pelvis forward. Pilates develops the awareness and muscular support to counteract this and reduce the resulting discomfort in the shoulders, neck, and lower back.
Mat Pilates vs reformer Pilates
Both mat-based Pilates and reformer Pilates are safe during pregnancy with appropriate modifications.
Mat Pilates is the more accessible option — it requires no equipment and can be done at home or in a studio. Antenatal mat Pilates classes are widely available and relatively affordable.
Reformer Pilates uses a spring-loaded carriage machine and can provide a more varied and progressive workout. It is generally safe in pregnancy when taught by an instructor experienced with prenatal clients. The reformer’s springs can actually be helpful in pregnancy, providing support and resistance in ways that mat work cannot. Tell your instructor you are pregnant before every session.
Modifications to make during pregnancy
First trimester
Your Pilates practice can continue largely as normal in the first trimester, though fatigue may mean you need to reduce intensity. Breathe continuously — avoid any breath-holding under exertion.
From the second trimester onwards
Avoid exercises lying flat on your back for more than a few minutes. After around 16–20 weeks, the weight of the uterus can compress the vena cava when lying supine, reducing blood return to the heart. Most antenatal Pilates instructors will automatically replace flat-back exercises with side-lying, seated, or kneeling alternatives.
Modify abdominal exercises — traditional crunches and sit-ups put unhelpful strain on the linea alba (the connective tissue running down the centre of the abdomen) and may worsen diastasis recti (separation of the abdominal muscles). Focus instead on deep core engagement — drawing the navel gently toward the spine — rather than outer abdominal flexion.
Pelvic floor work becomes increasingly important as pregnancy progresses. Practise both lifting and releasing the pelvic floor — releasing is as important as strengthening, particularly in preparation for birth.
Hip and glute work in side-lying is excellent at all stages and helps maintain pelvic stability as the pelvis changes shape during pregnancy.
When to stop and seek advice
Stop exercising and contact your midwife if you experience:
- Any pain in the pelvis, abdomen, or lower back that is new or sharp
- Dizziness, light-headedness, or feeling faint
- Shortness of breath disproportionate to your effort
- Any vaginal bleeding or fluid leakage
- Headache or visual disturbance
- Decreased fetal movement
Finding a class
Look for classes specifically advertised as antenatal Pilates or pregnancy Pilates. Instructors should hold a recognised antenatal exercise qualification and be able to offer appropriate modifications. Many leisure centres, physiotherapy practices, and Pilates studios offer dedicated antenatal courses. Online prenatal Pilates programmes are also widely available and offer good flexibility around appointment schedules.
Always tell your instructor you are pregnant and how many weeks you are, at every session.