Safiah, I am pregnant. Can I still come to your group reformer class?
That is the question I get from my pregnant Mamas who attend my group Pilates Reformer class. Especially because I have done my certification in teaching Pilates for prenatal and post natal, many clients assume that it is okay for them to continue attending my usual group reformer Pilates class. In case you are not familiar with the Pilates world, Reformer is one of the equipment created by Joseph Pilates. In my group Reformer Pilates class, I teach a set of selected exercises to a group of clients (each client to a reformer) for about an hour. Aside from group classes being more affordable for most, there is also the energy and mutual support you get when working out in a group.
Lately I am having to turn away several of my regular clients from my group reformer classes because they are pregnant and have past their first trimester. To compensate this I opened up a prenatal class every Sunday with a maximum of 5 people so I can make sure that all pregnant clients are all looked after, and most importantly safe.
For the first trimester, it’s okay for pregnant clients to attend my classes as usual even if it’s the Intermediate level, depending on their energy level. For some, the first trimester can be very challenging because of you know, the expected stuff: nausea, morning sickness and tiredness but for others they may feel absolutely fine and normal. During the first 12 weeks the foetus is still forming and isn't fully embedded in the womb so we would want to take it easy and at least wait past 12 weeks before doing exercise that is a little bit more dynamic, provided that they are pregnancy safe activities. What I would usually tell my pregnant clients is to take a break whenever they want to and start opting out from any abdominal exercises that involves forward flexion and planks (read point No 2 below). I would also tell them to pay attention to when they reach the end of their first trimester because dear Mamas, once you get into second trimester and into the third trimester, the Do's and Don'ts of exercise during pregnancy changes. When my pregnant clients reach their second trimester I will either move them on to the group prenatal class or offer them private sessions.
It is really hard turning away pregnant clients from my group classes especially when they are my regulars. And the few minutes gap we have in between classes is too short for me to chat and explain properly why they are not suitable to continue with the group reformer class. So I am writing this blog post to explain the reasons Why I turn pregnant clients away from my group Pilates class after they past the first trimester?
1. In general past 12 weeks, high impact or high intensity exercises are not encouraged because the bump gets bigger which means the womb is protruding and is less protected by the pelvic bones. So if the clients do high impact activities such as running, football or martial arts I would encourage them to switch to something low impact such as power walking, dance aerobic or swimming.
2. It is advised that after 16 weeks, for pregnant clients not to do exercises lying on their back for more than several minutes. The weight of the baby can press onto the mothers blood vessels, lowering her blood pressure (Supine Hypotension Syndrome). Technically a pregnant person’s head need to be higher then her heart when exercising. In Reformer Pilates class (beginner or intermediate) we sometimes spend half of the class lying on our backs! I usually adapt this by making the pregnant client lye back on a wedge cushion or on a jump board placed on the reformer carriage to prop their head up, or instead give them side lying exercises on the reformer. This wont work in a normal group class because this means I need to adapt / give variations to the pregnant client and it is not fair for other clients.
3. Curl ups or forward flexion (sit ups and crunches movement) is definitely a No No because it will encourage the separation of the mother's Rectus Abdominus (six packs tummy muscles) also called Diastasis Recti. Being pregnant alone or pushing hard during delivery can already give Diastasis Recti so why would I make the pregnant clients do curl ups exercises on the reformer?
After pregnancy if a mother has Diastasis Recti it is important that she gives it attention for recovery because in the long run if Diastatsis recti is not healed properly, it can affect the lower back. I have a client who only feels the effect of Diastasis Recti after 7 years of giving birth to her second child - this is hard to reverse but not impossible to heal. Remember prevention is better than cure.
4. Heavy springs and resistance can strain the pelvic floor. Not only but more so during pregnancy, the pelvic floor is super important. Think of the pelvic floor like a trampoline or a hammock. It has to be supple enough to stretch for when the baby come out but strong enough to carry the weight of the baby for most of the pregnancy as well as provide support to the bladder, uterus and bowel. More attention should be put on the health of the pelvic floor during pregnancy because it guides the baby’s head down the birth canal. The pelvic floor muscles are frequently weakened by pregnancy and childbirth due to the weight of the baby, hormonal changes, stretching the of the muscles during childbirth, so exercises and activities that requires lots of heavy lifting or carrying extra weight will not be doing the pelvic floor any favour. So if a pregnant client decides to attend their usual reformer classes and do exercises with heavy springs or resistance, they will not only work harder than they should for their bodily condition but subsequently will also overwork their pelvic floors which can lead to a weakened pelvic floor.
5. The further you are in pregnancy, the bump gets bigger and this will affect balance especially when doing standing exercises. And if in a usual group reformer class we were to do exercises that open both legs at the same time, such as standing split exercises or leg circles with feet in strap, this could also shift the pelvis.
Worst case scenario this can create separation of the pubic bones also called Pubic Symphasis Derangement. The ligaments soften during pregnancy due to hormones (to naturally allow the body to expand and assist delivery) so pregnant ladies are usually more flexible than usual. Therefore quick changes of movement with resistance when separating the legs are avoided.
I know that some other instructors are cool with having pregnant clients in their classes but after having all these knowledge it is hard for me to let the clients participate in the group class and turn a blind eye to the contraindications. Yes, pregnant clients may feel fine during class but the consequences are more long term. Its one thing wanting to feel the 'burn' in class but exercise programme during pregnancy must first of all be safe to not affect the delivery process or leave damage to the body post birth, and even better if they are also designed to assist the birth.
All the above may seem like there are a lot fear put onto exercising during pregnancy. That is why I run and teach Pilates prenatal classes because actually if exercises during pregnancy is done properly, especially the Pilates Method which integrates the body and mind, it can really benefit the mother and her baby. In my prenatal Pilates class, private or group, I teach exercises that strengthens the parts of the body that needs it and releases parts the body to prepare it for birth. I always tell my pregnant clients to look at labour and delivery like going for a marathon and that they need to train their body to be fit and ready but of course in not a damaging way.
I hope this clarify why I do not agree with having pregnant clients after first trimester in my usual group class. As you can see in the *photos above are the exercises I regularly teach in a group Pilates class and these exercises are also contraindications for pregnant ladies. And even if they can perform it well, now that I have explained all of the above can we see how unsafe it is for them?
*All photos found on Google search