The effects of Pregnancy in Pilates

Pregnancy is a special time for a mother-to-be to slow down, regain her energy, and connect just a little more with her mind and body. When pregnant, mindful exercise that has been approved by a doctor or gynaecologist is advised before starting and or continuing an exercise program. Pilates is one of the safest forms of exercise that is regularly recommended. This is especially true for pregnant women as Pilates allows for a deep mind-body connection while gaining strength, flexibility and alleviating pregnancy discomforts as well as assisting in the recovery post-pregnancy. This too is made with the assumption that the mother is working with a pregnancy qualified Pilates Instructor (see course recommendation by Principal Faculty Ashley Ritchie on “Pilates through Pregnancy and Beyond” part of the BASI Pilates Advanced Education Certificate Course).

When the mental aspect of body conditioning is included in the learning and reeducation process of exercise, it is evident that clients see far greater results. This is because the whole is addressed: body and mind. This can be realised through the appropriate choice of exercises within the BASI Block System, and The Ten BASI Pilates Principles namely, awareness, breathe, balance, control, centre, concentration, efficiency, flow, harmony and precision.

Today’s women have “take-away” pregnancies, “pregnancy-on-the-go”, life is busy and there is often a denial of the intensity and reality of pregnancy! There are many benefits to the mental and physical aspects of Pilates and pregnancy. Through Pilates, women are made more aware of their body and minds which gives them more balance and harmony in their lives. This results in greater self-confidence. Physically, Pilates requires good intention and efficiency of movement, while strengthening the pelvic floor, core muscles and maintaining a healthy balanced body. An emphasis is placed on good posture which minimises pregnancy aches and pains, varicose veins, water retention, and balances blood pressure. There is an enviable result of the flexibility of muscles and tendons, control of breath to help with labour, hip mobility as the stomach expands, and good preparation of the pelvis. This results in a quicker recovery post-pregnancy. When exercising endorphins are released which prevents postnatal depression and greater autonomy over their mental and physical state. What a wonderful gift, the mother has time to herself to just be!

An average pregnancy involves many essential hormones: Luteinizing, Follicle Stimulated Hormone, Human Chorionic Gonadotropin, Progesterone, Estrogen, and Relaxin. During the 37-42 week of pregnancy, the pregnancy is divided into 3 trimesters each lasting 3 months. Pregnancy is worked out from the date of the last menstrual period rather than the actual conception.

During the first trimester (0-14 weeks) the embryo is formed. Between 5-8 weeks the spinal column, nervous system, limbs and major organs are formed. By 21 days the heart is beating at 180 beats per minute and weighs 30g and is about 7.5cm. By 8 weeks the embryo becomes a foetus. The movement may be small but the mother can feel them. During Pilates the heart rate increases along with the mother’s and after pilates their heart rate lowers. Exercise should not exceed 70% of the mother’s maximum heart rate (220-age=maximum heart rate). Drinking water before, after and during exercise is critical, as the mother needs to stay hydrated and keep her core temperature below 38 degreed. The maternal hormonal changes are that progesterone and estrogen are growing fetal development. The hormone relaxin is higher, this makes the mother more mobile, her energy levels drop and morning sickness may start between 8-12 weeks. The morning sickness and nausea are as a result of higher Human Chorionic Gonadotropin. It is important to recognise that the mother’s mood may also swing with all these hormonal changes. The mother is encouraged to slow down and always listen to her body!

During the second trimester (15-27 weeks) the fetal growth continues to develop at a rapid rate. The fetas gets nails, hair and internal organs. Interestingly enough the internal organ that is not yet independently functional is the lungs. The skeleton starts to form and the fetus becomes sensitive to light and sound. The fetus is now moving around a lot even though heart rate drops to 145 beats per minute. The fetus weighs 600g to 750g and is about 22cm from head to gluteus. By 26 weeks the baby’s outline may be felt through the mother’s abdomen. The maternal changes continue with progestogen, oestrogen on the rise as well as estrogen, while Human Chorionic Gonadotropin decreases along with morning sickness and nausea. The mother will have an increased level of energy, although she will have put on weight making her look pregnant and she loses her waistline. Both core and skin temperature peaks in the second trimester. The gastrointestinal tract slows down. The baby takes what it needs from the mother so calcium levels decrease, resulting in osteopenic concerns! With the weight of the stomach increasing in the front line of the body the centre of gravity changes, back/leg pain, ankle, feet, hands, and face may also swell. Oestrogen and relaxin increase so the ligaments and joints become more unstable especially surrounding the pelvis. There are a lot of exercises that should be avoided at this stage until after giving birth, such as chest lifts, overworking the obliques, full roll downs, deep flexion and hypertension exercises, rapid movement, open-chain bilateral movement, loaded long lever abduction and adduction, holding isometric contractions, and finally lying supine for more than 4 minutes as it increases pressure on the vena cava which impairs the blood return to the mother’s head and heart.

During the third trimester (28 weeks until birth) the fetas are finally able to survive independently as their lungs are now developed. The baby becomes aware of sounds, and the pupils learn how to adjust to light. The baby can store fat under the skin and increases the store of maternal antibodies. This means that the baby can now fight off some diseases. At 40 weeks the baby weighs roughly 3.2kg and is around 50cm in length. While the baby is flourishing, the mother is still going through many many maternal changes. Oestrogen level reaches its peak, and progesterone is high. The mother is increasingly more tired as her heart rate increases by approximately 20%, that’s 15 beats extra per minute! Along with exhaustion, the mother gains additional weight which puts more pressure on her bladder, the level of hormones also softens the pelvic floor causing an increase in leaking urine. The mother’s uterus has grown 1000 times by 36 weeks! Bloods and fluids have increased by 40-50%. Physical changes such as backaches, stretch marks, swelling feet, and varicose veins can be present. By the end of the pregnancy, the mother should have gained roughly 12kg. With all these changes in the body, the mother needs to maintain upper body and arm strength to carry the baby. The exercise load needs to decrease and a greater focus on relaxation, breathing and changing positions frequently is needed. Continuing with oblique, vertical and horizontal sling exercises to stabilise and strengthen the body is recommended. Static (held) and supported stretching rather than dynamic (moving) stretching is important, particularly stretching into the lumbar (lower) back.

The main hormones to play a key role during natural labour and birth are oxytocin the “love hormone”, endorphins, the “feel-good chemicals” and adrenaline, the “fight or flight” response. This makes the mother and newborn alert when meeting one another and breastfeeding for the first time. A C-Section without labour fails to produce any of the natural oxytocin and endorphin experience. However, epidural pain relief has major effects on the above hormones of labour. Epidural mimic beta-endorphins release and shifts consciousness that’s part of normal labour.

The first 6 weeks post birth is a time for healing, re-balancing and recovery! It takes 6 weeks to 2 months for the mother’s genital organ to return to their original size. Relaxin can still be found in the body for up to 5 months making the mother’s joints and ligaments fragile and too mobile. This also puts tremendous stress on the lower back and pelvic floor. Prolactin is the hormone produced in the pituitary gland and makes milk for breastfeeding. This usually stops after about 5 months (until the mother stops breastfeeding she is considered to be osteopenia!).

Very gentle and light exercises such as kegal, breathing, drawing up transverse abdominals, and slow walking with a pram can be done post-pregnancy. Before the mother goes back to exercising and Pilates she must get her doctor’s consent. Typically post natural birth exercise may resume between 6-8 weeks, while C-section is considered serious surgery and the mother is only encouraged to go back to exercise between 8-10 weeks. Breastfeeding, and eating should be done before exercise. The mother must continue to listen to her body at all times and stops with anything should there be a pain.