How pilates and yoga can help in pregnancy

Fitness expert and physiotherapist Renée Vincent explains Pilates, yoga and yogalates and how they can help you in pregnancy and birth. 

Pilates, yoga and even yogalates are creating a good deal of buzz these days but if you’re pregnant what’s the difference between this type of exercise and, say, going for a walk? Also, which form is the best for a baby-carrying mama? I’m often asked by my pregnant clients which of these I would recommend and how they differ from each other but really, research suggests the benefits rate well for all three. 

Not so different…

When we look at the origins of yoga and Pilates we find they are similar in many ways. Yoga is an ancient mind-body practice that started thousands of years ago in India. It has been taken up in the west as people learned of its potential to enhance physical fitness, boost immunity and increase a sense of wellbeing.

In its traditional form, yoga works by creating a balance between mind, body and spirit. There are now many different types of yoga, some of which have changed focus as they became westernised, with the emphasis shifting more to stretching and increasing flexibility as opposed to optimising wellbeing.

When Joseph Pilates created the Pilates method in the early 20th century, the goals he had in mind were not dissimilar to those of traditional yoga. He developed an exercise/movement method that he claimed co-ordinated the body, mind and spirit and would lead to improved posture, physical development and revitalisation of the mind and spirit.

The traditional Pilates method was initially most popular among professional dancers as it required a reasonably athletic level of strength and flexibility. However, the term “Pilates” now covers various modified forms of the original method that are more appropriate for the general population.

More recently, new sequences of Pilates exercises have been created that incorporate the latest understanding of muscle and movement function and progress from basic to advanced levels.

A third option has appeared in some fitness arenas in the past few years: yogalates. As the name suggests, this aims to combine the best of both worlds. According to its founder, Louise Solomon (www.yogalates.com.au), “Yogalates effectively merges the ancient practice of yoga from the east with the core stabilising, posture-enhancing dynamics of Pilates from the west.”

If you were considering this as an option it’s important to check out the instructor’s qualifications as an instructor qualified in only one of these methods, but teaching both, or who doesn’t have formal training in either, could detract from the benefits or add to the risk of injury.

Do I need to be a pretzel or a ballerina?

Yoga will generally combine physical postures, breathing exercises, relaxation and meditation. Different types of yoga put these elements together in different ways. The slower, more controlled forms of yoga, which emphasise breathing and alignment, generally come under the term “Hatha yoga”. Iyengar yoga is also popular with beginners, or people who are recovering from injury, as it is a form of Hatha yoga that progresses from simple poses to more complex ones and can involve props to assist people into the postures.

These types of yoga usually form the base of a pregnancy yoga class. Yoga in a heated environment (Bikram yoga) and more vigorous forms such as Ashtanga or Vinyasa yoga are not recommended during pregnancy.

Like yoga, Pilates uses a system of physical postures but there is an emphasis on activating the trunk muscles (core) and on being able to separate movement of the arms and legs from movement at the trunk and pelvis (stabilisation). This is co-ordinated with breathing plus a focus on stretching. The modern Pilates exercise sequences allow clients to build their strength up progressively and to target weaknesses that have been caused by, or lead to, pain or injury.

During pregnancy women can generally do both mat and equipment Pilates as long as they are taught by an instructor who is trained in teaching pregnant women, as Pilates needs to be modified to make it safe. 

What are the benefits?

Firstly, the research is clear in supporting exercise in general during pregnancy. Specifically, the recommendation by the American College of Obstetricians and Gynecologists (ACOG) is that pregnant women exercise at least 30 minutes a day most days of the week. This is because research has clearly demonstrated the potential for exercise during pregnancy to reduce backaches, bloating, swelling and constipation. It also helps reduce the risk of gestational diabetes, improves your mood, energy and posture, promotes strength, endurance and flexibility and helps you sleep better.

But the question is whether doing yoga or Pilates gives you specific benefits above that of walking or other exercise.

Iyengar yoga instructor Vanessa Greenwood, from IYOGA in Auckland, says yoga offers pregnant women an opportunity to learn to relax and increase their energy levels, as well as improve their physical condition and help prevent problems related to our modern lifestyles.

“It’s vital to learn to relax during pregnancy, not only for the expecting mum but also for baby,” says Vanessa.

“Yoga offers women time-out — we are too busy these days and yoga helps to just slow things down and gain clarity.”

“Many women are working behind a computer and working late into the third trimester. I teach them what to do to give the body a chance to move and open, so there is no increase in the stiffness of joints, especially the hips, lower back and pelvic area.”

The scientific research supports Vanessa’s experience that yoga can be very valuable for pregnant women. A systematic review last year by Curtis, Weinrib and Katz, summarising the research to date on yoga for pregnant women, concluded that pregnancy yoga had benefits not only during pregnancy but also during labour and delivery.

Psychological benefits were noted, such as improved quality of life and belief in oneself, plus improvements in physical and pain measures during labour, as well as in measures related to the baby, with less chance of a low birth weight baby or pre-term birth.

Pilates is also believed to be particularly helpful during pregnancy because of its focus on abdominal muscles and pelvic floor activation, and also because of reported effects on posture, strength and flexibility in non-pregnant women.

Unfortunately, very little research has been done on the specific improvements that actually occur when women do Pilates during pregnancy.

There is, however, good-quality Research looking at non-pregnant participants suggesting Pilates can improve flexibility, dynamic balance and muscular endurance. Also, studies that compared traditional exercises to specific stabilisation exercise (similar to those used in clinical Pilates) found that Pilates is effective at reducing persistent lower back or pelvic pain — problems that can trouble pregnant women.

I asked Charlie Ruddenklau from Charlie’s Pilates in Auckland about the benefits she believed women can get from doing Pilates during pregnancy.

“When I teach women Pilates postnatally, I notice that the ones who have done Pilates during pregnancy seem to have a better understanding of the changes their body went through during pregnancy,” she says.

“They have benefited from having already learnt how to activate and exercise their core stability and pelvic floor muscles effectively and safely.”

Charlie believes this gives women a head start when they want to start postnatal rehabilitation. She believes the kind of benefits women can get from pregnancy-specific Pilates classes include “learning about their pelvic floor muscles, learning good bladder and bowel habits to protect the pelvic floor, learning how to support and protect vulnerable joints and how to exercise safely, and learning how to activate and strengthen their core stability muscles.”

In Charlie’s experience, this knowledge helps women to prepare their body for childbirth and the work of childcare. She feels a Pilates class also “allows women time to switch their mind into their body and this means that they come away from the class feeling relaxed”.

What are the risks?

In yoga, Pilates and yogalates the physical postures need to be modified to take into account the effect of the pregnant tummy on the woman’s centre of gravity and blood flow. After the first trimester it is not recommended that pregnant women exercise lying on their backs because the weight of the pregnant uterus affects the blood flow in the large artery that lies beneath it. It is also important that women realise there is a higher risk of injury to joints during pregnancy due to pregnancy hormones making the tissues that hold the joints together more elastic.

Movements need to be modified to avoid over-stretching and over-straining, and to minimise the risk of slipping, twisting or falling. Pregnant women are also unable to regulate their body temperature as well, so exercising in hot environments is not safe for the mother or baby. An instructor such as Vanessa, who is experienced in teaching classes to pregnant women, will be aware of these issues.

“The pelvic floor muscles, the walls of the vagina, the symphysis pubis, the lower back and also pelvic ligaments can be overloaded in pregnancy,” she explains. “Straining the pelvic ligaments is prevented by being aware of how to use the legs effectively to reduce hanging or over stretching, especially in the last trimester.”

At the end of the day…

So what would I tell a client who was wondering which to choose? I would conclude that both yoga and Pilates are forms of exercise that can be modified to work well for pregnant women.

One major difference between the two is that although Pilates requires the movements to be performed mindfully and this has some psychological and relaxation benefits, the focus is more on physical exercise. Yoga on the other hand has a spiritual aspect to it and a slightly more holistic focus.

For all clients I would recommend a qualified pregnancy specific instructor. For those concerned about pain or injury I would recommend an Iyengar instructor in yoga or a clinical Pilates instructor (usually a qualified health professional).

While yoga is ahead in terms of the research confirming its benefits during pregnancy, it is very likely that when taught well and modified for pregnancy, both yoga and Pilates can assist women to learn about their body and movement in a way that can help them through the stress and changes of pregnancy and strain of labour and delivery.

Fitness expert Renée Vincent is a physiotherapist at Total Mums in Auckland and mum.