Pregnancy & Pilates Pregnant women need to make some exercise adjustments By Greg Bonnell - CP

Maintaining a fitness regime can be challenging under normal circumstances. Throw pregnancy into the equation and suddenly there's a whole list of dos and don'ts to consider. Amid media reports that Julia Roberts is pursuing a fit pregnancy through Pilates and the multitude of instructional videos and DVDs available more and more women may be wondering if prenatal Pilates is the exercise for them.

I tell them to go ahead, but please give me a listing of what exercises you're doing, said Dr. Michael Helewa, president-elect of Society of Obstetricians and Gynaecologists of Canada. We recommend exercising in pregnancy as part of a healthy lifestyle. A lot of Pilates work is about core stability strengthening the deep support muscles of the torso to maintain a neutral alignment of the spine.

Toning of the abdominal wall as well as the pelvic wall muscles in pregnancy may reduce the risk of perineal tears and birth injuries, said Helewa, who practises at St. Boniface General Hospital in Winnipeg. It will make the woman more efficient in her pushing in the second stage of labour. But the many varied disciplines of Pilates and the multitude of routines demand that one proceed with caution.

Everybody's adding a little flavour to their so-called Pilates, said Helewa, who has talked to colleagues about the exercise and found there's little standardization of routines.

Providing the details of your particular brand to an obstetrician will allow for a safe and effective experience.

Plus, many instructors will want to know if you've been given a clean bill of health. First we make sure they have permission from their doctor, said Beth Evans, program director at Stott Pilates in Toronto.

Then we find out how far along she is so we can modify the exercise appropriately, said Evans. You do need to modify what you're doing. So what will your doctor and instructor tell you to avoid? For example, the woman should make sure she's not lying on her back for too long, especially in the later stages of pregnancy, said Helewa.

As the supine position is the one most commonly employed in Pilates, that eliminates a host of routines but there¹s plenty left over.

There is the squatting and the breathing exercises, the stretching most of these are fine, said Helewa.

It's all about substituting other positions for lying on your back including sitting, standing and getting down on all fours.

A great one is on all fours starting from a neutral position, said Evans. Arch your back up towards the ceiling, then come back to that neutral position, she said. That feels great, and it's a great position to work (the abdominal muscles). Noting that pregnant women sometimes develop a slouch due to the increased weight they'e carrying, Evans recommends strengthening the arms and shoulders to maintain proper posture.

In any exercise a pregnant woman undertakes, it's important she keeps her heart rate within target limits and never exercise to the point of breathlessness.

Pilates isn't targeting cardiovascular, said Evans. For most people you're not getting anywhere near the top of the recommended (heart rate) range. While responsible instructors will help guide your pregnant Pilates journey gradually easing up on the work load there¹s a large market for home-based workouts through instructional videos and DVDs.

Again, it¹s best to inform your doctor. Bringing the video along with you to an appointment isn¹t a bad idea either.

The physician can assess the risk and benefits of each exercise, and recommend which ones to use and which ones to avoid,² said Helewa.

After the baby is born and the chaotic pace of those initial weeks settles into a somewhat orderly existence, the new mother might be eager to resume Pilates.

You can't jump back right into what you were doing before, cautioned Evans. Basically, you have to build up again.

Canadian Press