So, how many times have you heard “She’s not ill, she’s pregnant! It’s the most natural thing!” ?

Yes, I agree, pregnancy is natural, but I do feel that sometimes this comment discounts all the changes that happen in a woman’s body during this period.  

In this blog, I thought that I might summarise these changes and explain how these changes would be accommodated to, ensuring a safe and effective form of exercise.  I will also explain how Pilates could help to minimise the possible negative knock on effects of these changes.

Posture, Muscles and Ligaments

The muscle that lengthens most dramatically is the rectus abdominis otherwise known as the six pack muscle. This muscle can lengthen throughout the pregnancy by 50cm! As muscles lengthen they become less efficient. As the foetus grows, the centre of gravity changes often, leading to changes in posture along with further changes in muscle lengths and their efficiency. The ligaments that support joints relax preparing for delivery but also leaving joints less supported in the meantime. This is where Pilates can help by optimising the muscles that work around the pelvis and all the joints of the body to offer support and appropriate flexibility. 

Many pregnant women also find that their awareness of their body in space (proprioception) is affected in pregnancy (often finding themselves walking into things!) Pilates focuses the mind on the body and helps to improve that awareness which makes correcting posture easier. Some pregnant women complain of pain in pregnancy as a result of these changes and working with a physiotherapist who understands these changes doing Pilates can help with this or, if done proactively, may even prevent it!


Hormone changes cause the smooth muscles of the bladder and urethers to not work as well.  Also, the pressure on the bladder increases, as the womb enlarges.  The pelvic floor supports the bladder and can help in the following ways:

  1. By improving the pelvic floor’s quick action, it will tighten when you cough or sneeze, preventing stress incontinence.
  2. By improving the pelvic floor’s stamina, this supports the bladder for sustained periods, helping to make the trips to the toilet not quite so frequent!

Respiratory System

As the womb enlarges, some women find that their breathing becomes shallow.  Effective lateral breathing is central to Pilates exercises and can help to address this.

Cardiovascular System

There is an increase in the woman’s heart rate and an increase in the blood volume, leading to an increase in the amount of blood the heart pumps around the woman’s body with each beat.  The blood also thins and the diameter of the blood vessels increases, leading to a decrease in blood pressure.  This can lead some women to feel dizzy, or short of breath, particularly when lying on the back.  

To accommodate this, slow changes of position would be ensured allowing the woman’s body to adapt and lying flat on the back would be avoided.

Digestive System

Changes in hormone levels slow the movement of food along the digestive tract.  This can lead to constipation, reflux and poor digestion.  Obviously changes to eating habits can help with this, but also working to have an effective pelvic floor, that contracts and relaxes appropriately, will also be helpful.

Fluid Retention

This is one of the joys of pregnancy and on occasions can lead to carpel tunnel syndrome with tingling numbness and pain in the hands.  This can make some arm positions difficult when exercising.  These positions would be avoided and exercises adapted.  Certain Pilates exercises would also be used to help pump the blood around the body and minimise congestion of that fluid.  


The pregnant woman’s body changes in so many ways, as discussed – posture, muscles, bladder, digestive system, and cardio vascular system.  All of this ensures that the growing baby gets all that it needs – nutrition and protection.  These changes are also preparing the body for the baby to be born.  

The body is truly amazing in making all these changes.  Pilates can allow the pregnant woman to optimise her body during this exciting time, and can also aid in some much needed relaxation.