More than two-thirds of pregnant women experience back pain, and six weeks after a first delivery, 60% of women in a Norwegian cohort presented abdominal rectus diastasis. Pilates, which works the core, breathing, and posture, thus attracts expectant and new mothers: in an Iranian trial of 110 first-time mothers, labor lasted an average of 170 minutes after 8 weeks of Pilates, compared to 248 without exercise.
This guide brings together studies identified via PubMed, contraindications for the pelvic floor, diastasis and postpartum recovery, with a typical session and a return-to-exercise plan.
During pregnancy : without contraindication, around thirty recommendations aim for 150 to 300 minutes of moderate activity per week, including strengthening and pelvic floor work. Exercise reduces the risk of gestational diabetes, gestational hypertension, and preeclampsia by approximately 40%. Prenatal Pilates trials, still small, show shorter labor and reduced lumbopelvic pain. After the first trimester, supine positioning, fall risks, and heat are limited.
After delivery : the pelvic floor comes first; trained during pregnancy in women without leakage, it probably reduces the risk of incontinence at the end of pregnancy by 62%. In a Norwegian cohort, 60% of women had diastasis, most often mild, six weeks after a first delivery, and exercise reduces the gap by only a few millimeters. Return to exercise is gradual, more cautious after cesarean section, and in a randomized trial exercise did not alter breast milk.
- Physical activity and pregnancy: what experts recommend
- Contraindications and warning signs
- Prenatal Pilates: what the trials show
- Back, pelvis, and mood
- Trimester by trimester: adapting your sessions
- Pilates reformer, ball, and wall Pilates during pregnancy
- Pelvic floor: the most studied training
- Rectus diastasis: what exercise can do
- Returning after delivery: timelines and stages
- Postpartum Pilates: fatigue, sleep, and mood
- Breastfeeding and nutrition: what the studies say
- Frequently Asked Questions
Physical Activity and Pregnancy: What Experts Recommend
A review of 30 public health recommendations, published in 11 languages, notes strong consensus: for uncomplicated pregnancy, 150 to 300 minutes of moderate-intensity aerobic activity per week, muscle strengthening and pelvic floor exercises, modification of certain exercises, particularly supine positions, and no activities involving falls or impact. Pilates falls under strengthening, alongside walking, stationary cycling, or aquatic exercise.
According to the Canadian recommendation published in late 2018, moderate effort noticeably accelerates heart rate but allows for conversation, not singing. It does not link physical activity to miscarriage, stillbirth, prematurity, or low birth weight; women already active may continue, others progress gradually.
Meta-analyses by the same team quantify the benefits: in randomized trials, exercise alone reduces the risk of gestational diabetes, gestational hypertension, and preeclampsia by approximately 40%, and a reduction of at least 25% required 600 MET-minutes per week, roughly 140 minutes of brisk walking. It also reduces instrumental delivery risk by 24%, with no association found with cesarean section or labor duration. The World Health Organization adds, for activity during pregnancy and after birth, a reduced risk of postpartum depression.
| Studied Effect | Result of Prenatal Exercise | Study |
|---|---|---|
| Gestational Diabetes | Odds ratio of 0.62, 6,934 women | Davenport, 2018 |
| Hypertension and Preeclampsia | 0.61 and 0.59 | Davenport, 2018 |
| Prenatal Depression | Odds ratio of 0.33, less severe symptoms (−0.38) | Davenport, 2018 |
| Weight Gain | −0.9 kg; excessive gain less frequent (0.68), insufficient gain slightly more frequent (1.32) | Ruchat, 2018 |
| Instrumental Delivery | −24%, 20 trials, 3,819 women | Davenport, 2019 |
| Back and Pelvic Pain | Less intense (−1.03), but not less frequent | Davenport, 2019 |
An effect size compares the difference between two groups to the variability of measurements: 0.2 indicates a small effect, 0.5 a medium effect, 0.8 a large effect. An odds ratio less than 1 signals lower risk with exercise.
Contraindications and Stop Signals
In a review of 11 recommendations from 9 countries, including France, the six texts that list contraindications agree on a common foundation: anemia, persistent bleeding, cardiovascular disease, cervical incompetence or cerclage, multiple pregnancy, preeclampsia or pregnancy-related hypertension, premature contractions or labor, premature rupture of membranes, thyroid disease. Four or five add diabetes, eating disorders, morbid obesity, and placenta previa.
With an absolute contraindication, the Canadian recommendation advises maintaining daily activities without more sustained effort; with a relative contraindication, the benefit of moderate to intense activity is weighed with the healthcare professional managing the pregnancy. A 2020 systematic review notes that these lists rely mainly on expert opinion: in 11 situations, such as gestational hypertension or twin pregnancy, potentially adapted activity could be beneficial. It reserves absolute contraindications for severe cardiorespiratory disease, placental abruption, vasa previa, uncontrolled type 1 diabetes, intrauterine growth restriction, premature labor, severe preeclampsia, and cervical insufficiency.
The six recommendations that list stop signals agree on three of them: dizziness or discomfort, shortness of breath before even exertion, vaginal bleeding. Five add abdominal or back pain, loss of amniotic fluid, and excessive shortness of breath. When encountering one of these signs, stop the session, sit down or lie on your side, and call your midwife, doctor, or maternity hospital.
In the first trimester, nausea and fatigue predominate: an older Canadian recommendation, cited in the same review, deemed the second trimester more suitable for starting, and the Japanese recommendation proposed waiting 12 weeks. Against nausea, see our article on ginger and pregnancy nausea.
Prenatal Pilates: what the trials show
Prenatal Pilates trials most often compare two sessions per week, over 8 to 12 weeks, to usual care in healthy pregnant women, often expecting their first child. A 2025 meta-analysis pooled 11 of them (538 participants, with only 3 trials at low risk of bias): Pilates was associated with shorter labor (effect size of −0.56), lower childbirth pain (−0.76), and a better Apgar score at one minute (0.41), each result based on 2 trials, with no significant effect on birth weight or delivery mode.
In healthy pregnant women, exercise shortened the active phase of labor by 56 minutes (8 trials, 1,195 women) and total labor duration (8 trials, 898 women) compared to no exercise. The expulsion phase did not change (7 trials, 1,135 women). But 5 of the 8 trials tested aerobics, water aerobics, or yoga, not Pilates.
Haseli A, Eghdampour F, Zarei H, et al. BMC Pregnancy Childbirth 2024;24(1):573. DOI: 10.1186/s12884-024-06785-5
In Iran, among 110 first-time mothers, 8 weeks of Pilates starting at 26 to 28 weeks reduced labor to 170 minutes on average compared to 248, with no significant difference for vaginal delivery (88% versus 81%), episiotomy, or Apgar. In Turkey, among 126 women, childbirth preparation combining classes, Pilates, and breathing techniques was followed by 80.6% vaginal deliveries versus 54.2%, without Pilates being isolated.
Across all forms of exercise combined, the Canadian meta-analysis of 113 studies linked prenatal exercise neither to cesarean delivery nor to labor duration: the specific effect of Pilates on labor remains to be confirmed. No serious adverse effects are reported; in an Australian feasibility trial of 6 weeks, all 11 women in the Pilates group completed the trial without any adverse event.
| Trial | Program | Main result |
|---|---|---|
| Ghandali, 2021, 110 first-time mothers | 2 sessions per week, 8 weeks | Labor of 170 versus 248 minutes; cesareans not different |
| Buran, 2024, 126 nulliparous women | Childbirth preparation with Pilates, 8 weeks | 80.6% vaginal deliveries versus 54.2%; less severe leakage |
| Yıldırım, 2023, 34 women with low back pain | 2 sessions of 60 minutes per week, 12 weeks | Disability at 2.7 points versus 10.9; sleep unchanged |
| Bulguroglu, 2025, 42 first-time mothers | 8 weeks, starting at 14 to 16 weeks | Stable ligamentous laxity, limited pelvic discomfort |
| Dias, 2018, 50 primiparous women | Pilates and pelvic floor contractions, 2 times per week | Pelvic floor strength by manometer not different from control group |
Back, pelvis and mood
Across all forms of exercise, a meta-analysis of 32 studies (52,297 women) shows that physical activity during pregnancy does not reduce the frequency of back or pelvic pain, but significantly reduces its intensity (effect size of −1.03, 15 trials; evidence of very low to moderate quality). For Pilates alone, a review identified only 2 trials (65 women), where pain decreased more than with standard follow-up (mean difference of −23.09 points out of 100, moderate quality evidence).
In 34 pregnant women at 14 to 24 weeks experiencing lumbopelvic pain, two 60-minute Pilates sessions per week for 12 weeks, using a ball, with slightly bent knees and without prolonged supine positioning, reduced disability score to 2.7 points versus 10.9 in controls, and median pain to 2 out of 10 versus 5. Anxiety and depression decreased; sleep quality did not change.
Yıldırım P, Basol G, Karahan AY. Turk J Phys Med Rehabil 2023;69(2):207-215. DOI: 10.5606/tftrd.2023.11054
In another Turkish trial of 42 primiparous women, 8 weeks of Pilates started at 14 to 16 weeks stabilized anterior cruciate ligament laxity and joint mobility, which increased in controls, and limited discomfort related to pelvic girdle pain.
Regarding mood, a network meta-analysis of 43 trials (3,843 women) attributes the most marked effects on perinatal depressive symptoms to Pilates (−1.50) and yoga (−1.01), with a still-wide interval for Pilates (−2.70 to −0.34); in women with depressive symptoms, aerobic exercise performed better.
Trimester by trimester: adapting sessions
In the supine position, the uterus can compress the aorta and vena cava: outside France and Spain, all international review recommendations advise against exercise in this position after the first trimester or 16 weeks, with the Canadian guideline suggesting side-lying, sitting or standing positions. A review of 7 studies (1,759 women) does not link these exercises to low birth weight, but 20 fetuses out of 65 (31%) showed cardiac arrhythmias during supine exercise, and uterine blood flow decreased by 13% compared to left side-lying rest: the data allow neither reassurance nor prohibition.
In practice, the hundred, supine abdominal work or sustained bridge give way to side-lying versions, quadruped positions or seated positions on a ball; the Turkish trial maintained the hundred and bridge, but without prolonged supine positioning.
Balance also changes: in a cohort of 2,847 working women, 26.6% had fallen during pregnancy. Recommendations exclude fall-risk activities; two note that hormones loosen ligaments. Standing exercises are performed near a wall, with slow transitions and a non-slip mat rather than a soft surface; our NUTRITION•PRO Pilates Mat combines a microsuede covering with a non-slip rubber base.
A review of 12 studies (347 women) found no core temperature exceeding 39°C, the threshold associated with malformation risk, even after 35 minutes of exercise at 80 to 90% maximum heart rate in 25°C conditions; however, several recommendations advise against exercise in hot or humid weather, thus heated indoor classes. The Canadian guideline of that time also advised against breath-holding during exertion.
Pilates reformer, ball and wall Pilates during pregnancy
We found no trials of the reformer during pregnancy in PubMed: this guide's data concern mat Pilates. On the machine, the mobile carriage challenges balance, many exercises are performed lying on the back, and springs invite loading. In practice: carriage locked for mounting and dismounting, seated, kneeling, or side-lying exercises, light springs, and an instructor trained in prenatal Pilates.
The ball, by contrast, appears in several trials, including the Turkish trial on lumbopelvic pain: sitting on it, you mobilize the pelvis without loading the back. Pilates at the wall has not been studied; the wall provides useful support for standing exercises, but legs-on-wall exercises are performed lying on the back.
Mat Pilates, that of the Brazilian trial and Turkish trials, remains the best-documented form. Our NUTRITION•PRO Pilates Mat, with a non-slip rubber base that anchors each posture to the ground, accompanies these sessions at home and in the studio.
Pelvic floor: the best-studied training
Approximately one in three women suffers from urinary incontinence after childbirth, and up to one in ten from fecal incontinence, according to the 2020 Cochrane review (46 trials, 10,832 women); the World Health Organization recommends training the pelvic floor daily.
In pregnant women without leakage at baseline, pelvic floor training during pregnancy probably reduces the risk of urinary incontinence at the end of pregnancy by 62% (6 trials, 624 women, moderate quality), and by 29% between three and six months after birth (5 trials, 673 women, high quality). In women who already had leakage, its therapeutic effect remains uncertain.
Woodley SJ, Lawrenson P, Boyle R, et al. Cochrane Database Syst Rev 2020;5(5):CD007471. DOI: 10.1002/14651858.CD007471.pub4
For the first year after birth, a 2025 meta-analysis associates pelvic floor training with a 37% reduced risk of urinary leakage (odds ratio 0.63, 7 trials, 1,930 women) and a 56% reduced risk of prolapse, this latter result based on a single trial of 123 women.
In 62 women, outside pregnancy, without notable pelvic disorder, 24 one-hour Pilates sessions strengthened the pelvic floor with no significant difference compared with specific training (+6.2 and +6.6 cmH2O). In 50 pregnant women, Pilates incorporating pelvic floor contractions did not perform better than standard exercise on manometer-measured strength. In the Turkish birth preparation trial, leakage was less severe up to one month after delivery, though the Pilates contribution could not be isolated. The safest approach remains to integrate true pelvic floor contractions into sessions.
Sitting or lying on your side, squeeze and lift the muscles that hold urine and gas, without tightening the buttocks or holding your breath; hold for a few seconds, then release completely. If in doubt, a midwife or physical therapist can verify the contraction.
Diastasis recti: what exercise can do
Diastasis is the separation of the rectus abdominis muscles along the linea alba. In a Norwegian cohort of 300 first-time pregnant women, a gap of at least two finger-widths concerned 33.1% at 21 weeks of pregnancy, 60% six weeks after birth, 45.4% at six months, and 32.6% at one year. At one year, women with or without diastasis did not report greater lumbopelvic pain.
In 175 first-time mothers, 4 months of weekly supervised classes combining pelvic floor and abdominal strengthening, started six weeks after delivery and supplemented by daily pelvic floor exercises at home, did not reduce the frequency of diastasis: 55.2% and 54.5% of women were affected at baseline, with no difference between groups at six months or one year.
Gluppe SL, Hilde G, Tennfjord MK, et al. Phys Ther 2018;98(4):260-268. DOI: 10.1093/ptj/pzy008
On the gap itself, the effect is modest: a review of 16 trials finds, with moderate certainty from 6 trials, a reduction of 0.43 cm with abdominal exercises, deemed not clinically significant by its authors. The 2025 meta-analysis finds −0.52 cm at rest and notes that no clinically important gap threshold has been established: a large gap may pose no problem if the linea alba tenses with effort.
Torso curling brings the two muscles closer: in 26 women with diastasis, it reduced the gap by 1.19 cm above the umbilicus but created more deformation of the linea alba, which deformed less when the transverse muscle was contracted first. Pilates, which combines breathing, transverse engagement, and controlled curling, incorporates these principles: in a non-randomized controlled study of 35 first-time mothers, four weeks of Pilates, five times per week, reduced the gap and waist circumference and improved abdominal endurance compared with controls, a result to be confirmed.
Lying on your back, knees bent, lift your head and shoulders, then palpate the midline at the umbilicus, 4.5 cm above and 4.5 cm below: in the Norwegian cohort, a gap of at least two finger-widths, or bulging, defined diastasis. In case of a large gap, bulging, or pain, a physical therapist or midwife adapts the exercises; our article flat belly: what really works complements this point.
Returning to exercise after childbirth: timelines and stages
According to a review of recommendations from 22 countries, most advise progressive return: Austria from 4 to 6 weeks, the United Kingdom after the postnatal visit at 6 to 8 weeks, France after the postnatal consultation, with 15 minutes daily 3 to 5 times per week, then at least 30 minutes 3 times per week after the 6-month checkup. The World Health Organization ultimately aims for 150 minutes of moderate activity per week, with strengthening and gentle stretching, and a return decided with a healthcare professional after cesarean delivery.
Qatar recommends 4 to 8 weeks after vaginal delivery but 8 to 12 weeks for cesarean, and after cesarean, no abdominal work before 4 months and no impact sport before 3 to 4 months; Iceland requires at least 6 weeks of caution after cesarean, without lifting anything heavier than the baby. Only France distinguishes vaginal delivery with or without episiotomy, which often lengthens recovery, the authors note.
Walking remains the foundation: French guidelines recommend 3,000 steps in 30 minutes after the 6-month checkup and advise against having days with fewer than 5,000 steps; our guide how many steps per day provides additional benchmarks.
Postpartum Pilates: fatigue, sleep and mood
Two articles from the same Iranian team report the same program, home-based Pilates for 30 minutes five times per week for 8 weeks, starting 72 hours after delivery, compared to no intervention, in 80 women (40 per group).
In 80 young mothers, this program resulted in significantly lower fatigue scores than controls across all measured dimensions: general fatigue 7.80 versus 12.72, physical fatigue 7.12 versus 10.42, mental fatigue 6.85 versus 10.72.
Ashrafinia F, Mirmohammadali M, Rajabi H, et al. Singapore Med J 2015;56(3):169-173. DOI: 10.11622/smedj.2015042
In 80 women having their first child, the same protocol improved subjective sleep quality, sleep onset, and daytime functioning, without changing sleep duration or efficiency. These studies remain modest and conducted in a single country; the 72-hour timeframe should be discussed with the midwife, especially after a cesarean section.
Regarding mood, the network meta-analysis cited above found mind-body exercises, including Pilates and yoga, particularly effective after childbirth (−1.60). Exercise during pregnancy did not change the risk of postpartum depression in the Canadian meta-analysis: it is the programs conducted after delivery that show an effect. Our NP Pilates Mat, which rolls up easily, can be taken out for a 30-minute session at home.
Breastfeeding and nutrition: what the studies say
In a randomized trial of 33 sedentary breastfeeding women, the 18 in the exercise group followed 45 minutes of aerobic exercise 5 days per week for 12 weeks starting 6 to 8 weeks after delivery: their aerobic capacity improved by 25%, compared to 5% in controls, with no difference in milk volume or composition, or infant weight gain.
Of 22 national recommendations, 7 specify that physical activity does not modify milk quantity, evidence that Australia rates as very low quality; Qatar recommends breastfeeding before exercise or one hour after. On lactation, see our article on fenugreek and breastfeeding.
During pregnancy, supplementation should be decided with the midwife or physician: folic acid (see our guide on vitamin B9 during pregnancy), as well as vitamin D and omega-3s, evaluated by two Cochrane reviews.
For vitamin D, the 2024 review calls for caution: after quality control, 20 of the 30 studies from the previous version were put on hold. Compared to placebo or no supplement (8 studies, 2,313 women), its effect on preeclampsia, gestational diabetes, and prematurity is very uncertain; it could reduce the risk of severe postpartum hemorrhage, according to a single study, and low birth weight, without the opposite being ruled out. The review notes that deficiency during pregnancy is associated with complications in mother and child, and notes that data on adverse effects are lacking.
If supplementation is chosen, our Plant-based Vitamin D3 provides 1,000 IU (25 µg) per drop; during pregnancy and breastfeeding, consult your midwife or physician first. Our articles on lichen vitamin D3 and vitamin D overdose complement this point.
Omega-3s have stronger evidence: according to the 2018 Cochrane review (70 trials, 19,927 women), long-chain omega-3s taken during pregnancy reduce the risk of premature delivery before 37 weeks (11.9% versus 13.4%, high-quality evidence) and before 34 weeks (2.7% versus 4.6%), but probably increase pregnancies extended beyond 42 weeks (2.6% versus 1.6%); no conclusions can be drawn regarding postpartum depression. Our Omega 3 Omegavie provides 640 mg of EPA and 440 mg of DHA per 4 capsules (trials used varied intakes, not this formula); during pregnancy and breastfeeding, any supplementation should be done on medical advice. See also our article on omega-3 effects.
A microsuede cover, soft and absorbent even during long sessions, on a non-slip rubber base that anchors each posture to the floor. Thin and stable, it prioritizes balance and movement precision, and rolls up in one motion to move from living room to studio.
See the Pilates MatOur Vegetable Vitamin D3 provides 1,000 IU per drop; during pregnancy and breastfeeding, first seek advice from your midwife or doctor.
Frequently Asked Questions
Can you do Pilates while pregnant?
Yes, if the pregnancy is progressing normally and after advice from your midwife or doctor. About thirty recommendations suggest 150 to 300 minutes of moderate activity per week, with strengthening and pelvic floor exercises, and prenatal Pilates trials have reported no serious adverse effects.
What are the benefits of Pilates for pregnant women?
In still-small trials, prenatal Pilates is associated with shorter labor, less intense lower back and pelvic pain, and fewer depressive symptoms. Exercise during pregnancy also reduces the risk of gestational diabetes and preeclampsia.
What are the contraindications to Pilates during pregnancy?
Recommendations notably cite persistent bleeding, placenta previa, cervical insufficiency or cerclage, premature labor, rupture of membranes, preeclampsia, multiple pregnancy, anemia, and certain heart, respiratory, or thyroid conditions. Activity is then suspended or adapted with the doctor.
Can you do Pilates in the first trimester?
Yes, if you were already practicing and the pregnancy is normal. To begin, an older Canadian recommendation considered the second trimester more favorable, and prenatal Pilates trials most often started between 14 and 30 weeks.
Which Pilates exercises should be avoided during pregnancy?
After the first trimester, prolonged exercises on the back, such as the hundred, are replaced by side-lying, seated, or all-fours positions. Avoid also positions on the stomach, exercises with fall risk, breath-holding, heavy loads, and heated studio classes.
Can you do reformer Pilates while pregnant?
No trial has evaluated the reformer during pregnancy. If practiced, it is better to have an instructor trained in prenatal Pilates, light springs, seated, kneeling, or side-lying exercises, and great caution when getting on and off the carriage.
Does Pilates strengthen the pelvic floor?
Partly: in 62 women, outside pregnancy, without notable pelvic disorder, Pilates strengthened the pelvic floor with no significant difference from specific training, but no better than standard exercise in 50 pregnant women. Specific pelvic floor training remains the most studied: in women without leakage, it probably reduces the risk of leakage by 62% at the end of pregnancy.
When can you resume Pilates after childbirth?
Breathing, pelvic floor, and walking resume early if delivery went well. Recommendations place the resumption of a structured program around the postnatal visit, between 4 and 8 weeks after vaginal delivery depending on the country, later after a cesarean, always progressively.
Can you do Pilates after a cesarean?
Yes, but more progressively. Qatar recommends waiting 8 to 12 weeks and delaying abdominal exercises to 4 months; Iceland recommends carrying nothing heavier than the baby for 6 weeks. The World Health Organization recommends discussing it with a healthcare professional before resuming.
Is Pilates effective against diastasis?
Abdominal exercises reduce the gap between the rectus abdominis muscles by approximately 0.4 to 0.5 cm in meta-analyses, and one non-randomized Pilates study supports this. In cases of large separation or bulging, an assessment with a physical therapist is necessary.
Can you do Pilates while breastfeeding?
Yes. In a randomized trial, 12 weeks of aerobic exercise in breastfeeding mothers did not change the volume or composition of milk, nor the weight gain of babies. Remember to drink plenty of water and breastfeed before your workout if your breasts feel full.
Sources
The studies cited below were identified via PubMed.
- Hayman M, Brown WJ, Brinson A, et al. Global public health recommendations on physical activity during pregnancy: a scoping review. British Journal of Sports Medicine, 2023;57(14):940-947. DOI
- Mottola MF, Davenport MH, Ruchat SM, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Journal of Obstetrics and Gynaecology Canada, 2018;40(11):1528-1537. DOI
- Davenport MH, Ruchat SM, Poitras VJ, et al. Prenatal exercise to prevent gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 2018;52(21):1367-1375. DOI
- Davenport MH, Ruchat SM, Sobierajski F, et al. Effect of prenatal exercise on maternal risk, labor and delivery: a systematic review and meta-analysis. British Journal of Sports Medicine, 2019;53(2):99-107. DOI
- Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 2020;54(24):1451-1462. DOI
- Davenport MH, McCurdy AP, Mottola MF, et al. Effect of prenatal exercise on anxiety and depressive symptoms during and after pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 2018;52(21):1376-1385. DOI
- Ruchat SM, Mottola MF, Skow RJ, et al. Effectiveness of exercise to prevent excessive weight gain during pregnancy and postpartum weight retention: a systematic review and meta-analysis. British Journal of Sports Medicine, 2018;52(21):1347-1356. DOI
- Davenport MH, Marchand AA, Mottola MF, et al. Exercise for the prevention and treatment of low back, pelvic, and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 2019;53(2):90-98. DOI
- Evenson KR, Barakat R, Brown WJ, et al. Physical activity recommendations during pregnancy: comparisons across countries. American Journal of Lifestyle Medicine, 2014;8(2):102-121. DOI
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- Li Y, Lu H, Zhang L, et al. Pilates during pregnancy: systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 2025;17(1):20. DOI
- Haseli A, Eghdampour F, Zarei H, et al. Optimizing labor duration through Pilates: systematic review and meta-analysis of randomized trials. BMC Pregnancy and Childbirth, 2024;24(1):573. DOI
- Ghandali NY, Iravani M, Habibi A, Cheraghian B. Efficacy of a Pilates program during pregnancy on labor progression: randomized clinical trial. BMC Pregnancy and Childbirth, 2021;21(1):480. DOI
- Buran G, Erim Avcı S. Effect of childbirth preparation combined with prenatal Pilates on urinary incontinence and labor progression: randomized controlled study. Archives of Gynecology and Obstetrics, 2024;310(5):2725-2735. DOI
- Mazzarino M, Kerr D, Morris ME. Feasibility of Pilates in pregnant women: randomized trial. Journal of Bodywork and Movement Therapies, 2022;32:207-212. DOI
- Yıldırım P, Basol G, Karahan AY. Pilates-based therapeutic exercise against low back and pelvic pain in pregnancy: prospective randomized controlled trial. Turkish Journal of Physical Medicine and Rehabilitation, 2023;69(2):207-215. DOI
- Bulguroglu M, Bulguroglu HI, Degirmenci B, et al. Efficacy of a prenatal Pilates program on ligamentous laxity and joint hypermobility in pregnant women: two-center randomized trial. BMC Pregnancy and Childbirth, 2025;25(1):897. DOI
- Dias NT, Ferreira LR, Fernandes MG, et al. Is a Pilates program with pelvic floor muscle contraction effective in pregnant women? Randomized controlled trial. Neurourology and Urodynamics, 2018;37(1):379-384. DOI
- Ferraz VS, Peixoto C, Ferreira Resstel AP, et al. Effect of the Pilates method on pain and quality of life during pregnancy: systematic review and meta-analysis. Journal of Bodywork and Movement Therapies, 2023;35:220-227. DOI
- Jiang R, Shu L, Li Y, et al. Efficacy of exercise on depressive and anxious symptoms during the perinatal period: network meta-analysis and dose-response analysis. International Journal of Gynaecology and Obstetrics, 2026;173(3):1308-1324. DOI
- Mottola MF, Nagpal TS, Bgeginski R, et al. Is supine exercise associated with adverse effects on mother and fetus? Systematic review. British Journal of Sports Medicine, 2019;53(2):82-89. DOI
- Dunning K, LeMasters G, Levin L, et al. Falls among pregnant workers: risk factors, occupational hazards, and high-risk occupations. American Journal of Industrial Medicine, 2003;44(6):664-672. DOI
- Ravanelli N, Casasola W, English T, et al. Thermal stress and fetal risk, environmental limits of exercise and passive heat exposure during pregnancy: systematic review with synthesis of best evidence. British Journal of Sports Medicine, 2019;53(13):799-805. DOI
- Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training to prevent and treat urinary and fecal incontinence during and after pregnancy. Cochrane Database of Systematic Reviews, 2020;5(5):CD007471. DOI
- Beamish NF, Davenport MH, Ali MU, et al. Effect of exercise postpartum on pelvic floor disorders and diastasis rectus abdominis: systematic review and meta-analysis. British Journal of Sports Medicine, 2025;59(8):562-575. DOI
- Culligan PJ, Scherer J, Dyer K, et al. Randomized clinical trial comparing pelvic floor muscle training to a Pilates program for perineal strengthening. International Urogynecology Journal, 2010;21(4):401-408. DOI
- Sperstad JB, Tennfjord MK, Hilde G, et al. Diastasis rectus abdominis during pregnancy and 12 months postpartum: prevalence, risk factors, and lumbopelvic pain. British Journal of Sports Medicine, 2016;50(17):1092-1096. DOI
- Gluppe SL, Hilde G, Tennfjord MK, et al. Effect of a postpartum training program on the prevalence of diastasis rectus abdominis in primiparous women: randomized controlled trial. Physical Therapy, 2018;98(4):260-268. DOI
- Benjamin DR, Frawley HC, Shields N, et al. Conservative interventions may have little effect on diastasis rectus abdominis postpartum: systematic review and meta-analysis. Physiotherapy, 2023;119:54-71. DOI
- Lee D, Hodges PW. Linea alba behavior during trunk curl-up in cases of rectus abdominis diastasis: an observational study. Journal of Orthopaedic and Sports Physical Therapy, 2016;46(7):580-589. DOI
- Lee N, Bae YH, Fong SSM, Lee WH. Effects of Pilates on rectus abdominis separation, rectus abdominis thickness, waist circumference, and abdominal endurance in primiparous women. BMC Women's Health, 2023;23(1):626. DOI
- Evenson KR, Brown WJ, Brinson AK, et al. Review of public health recommendations on physical activity and sedentary behavior after childbirth worldwide. Journal of Sport and Health Science, 2024;13(4):472-483. DOI
- Ashrafinia F, Mirmohammadali M, Rajabi H, et al. Effect of Pilates on maternal fatigue after childbirth. Singapore Medical Journal, 2015;56(3):169-173. DOI
- Ashrafinia F, Mirmohammadali M, Rajabi H, et al. Effects of Pilates on sleep quality in postpartum women. Journal of Bodywork and Movement Therapies, 2014;18(2):190-199. DOI
- Dewey KG, Lovelady CA, Nommsen-Rivers LA, et al. Randomized trial of the effects of aerobic exercise by lactating women on the volume and composition of breast milk. New England Journal of Medicine, 1994;330(7):449-453. DOI
- Palacios C, Kostiuk LL, Cuthbert A, Weeks J. Vitamin D supplementation in pregnant women. Cochrane Database of Systematic Reviews, 2024;7(7):CD008873. DOI
- Middleton P, Gomersall JC, Gould JF, et al. Omega-3 fatty acid intake during pregnancy. Cochrane Database of Systematic Reviews, 2018;11(11):CD003402. DOI
