Reformer Pilates During Pregnancy: What's Safe, What to Modify

Pregnancy raises a lot of questions about what's still okay to do, and reformer Pilates comes up often. The short answer is that it's generally safe for most healthy pregnancies, with the right modifications and your doctor's clearance, but the details matter more than the headline.

Should you start reformer Pilates for the first time while pregnant?

If you've already been doing reformer Pilates before falling pregnant, continuing with appropriate modifications is usually fine and often beneficial. Starting completely fresh during pregnancy is a slightly different conversation. Most guidance suggests it's not contraindicated, but it's not the moment to walk into a busy group class and figure it out as you go either.

If you're new to the reformer and pregnant, a one on one session first makes a lot of sense. It gives us the chance to assess your baseline and understand what trimester you're in and how you're feeling, and build modifications into your program from the very first session rather than trying to adapt on the fly in a group setting. Once you're comfortable, moving into a small group class is usually straightforward.

Either way, check in with your GP or obstetrician before starting or continuing, particularly if your pregnancy has any specific considerations.

First trimester

If you were already doing reformer Pilates, you can generally keep going much as before. The biggest factor in the first trimester tends to be fatigue and nausea rather than any exercise restriction, so it's more about listening to your energy levels than following a strict list of dos and don'ts.

Tell the physiotherapist you're pregnant as soon as you know, even if you're not telling everyone else yet. It's useful information for us to adapt your session safely, and it stays between us.

Second trimester

This is usually the trimester where modifications start to matter more. Your centre of gravity is shifting as your belly grows, which changes your balance in ways that catch people off guard on exercises they'd normally find easy.

From around 16 to 20 weeks, we'll start moving you away from lying flat on your back for extended periods. Lying supine can compress a major vein and reduce blood flow, which can leave you feeling dizzy or short of breath. This is easily managed on a reformer by propping you up on an incline using a wedge or bolster instead of lying completely flat, so you're not missing out on the exercise, just doing it in a position that works better for where you're at.

Third trimester

Energy often dips again here as your body carries more weight and your centre of gravity keeps shifting. This is the trimester where we lean hardest into modification: avoiding deep abdominal flexion (think exercises that compress your belly, like a full Hundred), being mindful of your loosened ligaments from the hormone relaxin, which increases injury risk if you push range of motion too far, and keeping a close eye on how you're feeling throughout the session rather than pushing through discomfort.

Balance and stability work becomes more important here too, partly for comfort and partly because it's useful preparation for labour and the early postpartum period.

Signs to stop and check in

Straightforward tiredness or muscle fatigue is normal. Dizziness, unusual shortness of breath, any pain that feels sharp or wrong rather than just "working," or reduced baby movement are not things to push through. Stop, let the physiotherapist know, and follow up with your GP or obstetrician if anything feels off.

Why a class run by a physiotherapist makes this easier

This is really where a reformer class run by a physiotherapist has a real advantage over a standard studio setting. Because it's a physiotherapist adjusting your program, not just a Pilates instructor running a fixed sequence, modifications for your trimester, your energy levels on a given day, or any discomfort specific to pregnancy, like pelvic girdle pain can be built into your session in real time rather than requiring you to sit exercises out.

Our group classes are capped at five people, which means there's always someone actually watching your form and checking in, not just calling out cues from the front of a crowded room. And if you'd prefer to start with individual attention before joining a group, one on one sessions with the physiotherapist are available, booked as an extended consultation.

Getting started

If you're pregnant and interested in starting or continuing reformer Pilates, get clearance from your GP or obstetrician first, then get in touch and we'll talk through where you're at and what makes sense. You can book a group class online, or for a one on one session, book an extended consultation. You can also read more about our reformer Pilates program in West Perth.

This article is general information, not a substitute for individual medical advice. Always get clearance from your GP or obstetrician before starting or continuing an exercise program during pregnancy.