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What is pilates? Most people think of Pilates as a new form of exercise because of the recent surge of popularity in the fitness and healthcare industry, in reality it’s been around for the past eighty years, invented by Joseph Pilates.

Pilates was a sickly child with asthma. To help fight his illness and build his strength, he experimented with various mind-body disciplines and later became an accomplished skier, diver, gymnast, and boxer. While in internment during WWI in England, he taught fellow interns his concepts and exercises that he developed over 20 years of self-study and apprenticeship in yoga, Zen, and ancient Greek and Roman physical regimens.

During this time, Pilates began devising the system of original floor exercises known today as “Pilates mat work". Within a few years, he became a nurse to the many internees under care with wartime disease and physical injury. Here, he began devising exercise apparatus to rehabilitate the patients by taking springs from the beds and rigging them to create spring resistance and "movement" for the bedridden. This “system” formed the foundation for his style of body conditioning used today.

In many ways, Pilates equipment today is not much different than it was back then. The use of spring tension, straps, supports for back, neck and shoulders are the same uses of the equipment today. The nature of the equipment is to both challenge and support the body as it learns to move more efficiently.

The benefits of Pilates method of movement therapy exercises for women thru pregnancy and postpartum is mostly misunderstood. Simply put, Pilates is a safe and effective approach to exercise for pregnant women to assist with breathing, body alignment and to recover body shape and tone after birth. I personally thank Pilates for preparing me for child birth and helping me get my midsection back to pre-pregnancy state after two children.

Pilates focuses on breathing which primarily helps activate the transversus abdominus. The transversus abdominus is the deepest of the abdominal muscles and is responsible for supporting the lumbar spine and pelvic area at a time when ligaments are lax due to the natural hormone relaxin excreted by the body while pregnant and nursing. Research has shown that activation of the transverses abdominus also activates the pelvic floor, keeping these muscles strong and supple for the birthing process can also help with any incontinence that you may experience during and after pregnancy. Lateral breathing also inherent in Pilates fitness improves rib cage mobility when the range of motion in the diaphragm is limited due to the high position of the baby in the third trimester.

Back pain unfortunately is also a common side effect of pregnancy. Unless we take the time to strengthen the abdominal muscles, pelvis and lower back, problems can occur. Strengthening the transversus abdominus (abdpminalss) through guided Pilates movements will not only improve back pain and postural alignment, but will aid women during labor for a much quicker & safer delivery.

The nature of movement in Pilates exercise is low impact which allows pregnant women to exercise effectively without experiencing any undue stress on the now lax joints, or an increased heart rate. Pilates also involves many stretching and toning exercises which helps to maintain hip flexibility and stamina, essential for well-being and preparation for childbirth. These exercises can be supported and modified by Pilates apparatus such as the reformer: a moving carriage on a bed; the wunda chair with springs to create resistance and the trapeze table to hang from. Pilates exercises also can be performed on a mat with small props such as pillows or cushions which supports the head, the magic circle, foam rollers and therabands for extra resistance.

Most exercise modifications happen during the second and third trimester due to the ever-increasing belly. All Pilates movements, at this point are best done seated up right or side lying. However, you can work supine as long as the head is elevated with pillows at 30 degrees above the heart for no longer than 6 minutes, turning to the side for a break. This ensures natural blood flow and oxygen to the fetus.

A popular exercise among pregnant Pilates enthusiasts is legwork on the wunda chair. It involves sitting or standing on a small stool with springs attached to a lever and pushing the lever down with your feet. This Pilates movement provides conditioning for the legs and activation of the abdominal muscles which stabilize the pelvis.
Arm work on the reformer not only targets the arms but the core at the same time, building strength in the upper-body is essential for preparation of holding a child for many years to come.

Below I have personally put together some modified mat Pilates exercises together which I found very beneficial to me through pregnancy as I experienced some back pain mostly due to poor posture.

CHEST OPENER WITH TOWEL
The muscle focus of this exercise is stretching out tight shoulders and opening the chest, these muscles are usually tight through pregnancy due to the weight of the belly and the upper body compensating.

Start sitting crossed legged on the floor or a chair depending on what feels most comfortable to you. Holding a rolled up towel in your hands, extend your arms in front of your chest with the towel taught pulling your hands away from each other. Exhale take the arms over head and continue past your ears until you comfortably feel the stretch in the chest and shoulders. Hold this position for 4 breath cycles then bring the arms back to the start position on a exhale. Repeat this for 5 times.

SIDE STRETCH WITH TOWEL
The muscle focus of this exercise is to stretch out the side of the waist obliques and lats, I found this stretch extremely beneficial through my first pregnancy due to lower back pain.

Start in the same position as the chest opener, exhale reaching over to the side placing your hand closest to the floor on the mat keeping the towel taught resisting your hands away from each other increasing the stretch in the side of the torso. Hold this position for 4 breath cycles, return back to starting position on an exhale focusing on the obliques to bring you back to an erect position.

SPINE STRETCH
The main focus of this exercise is to stretch and strengthen the upper-back and activate you core muscles which will decrease back pain and help correct your pregnancy posture. There are few extension exercises you are able to do whilst pregnant as obviously we are unable to lie on our bellies making this a perfect choice for pregnancy.

1. Start on the floor sitting up tall with your legs shoulder width apart, hands directly in front of you chest height.
   
   
2. Exhale drawing in the abdominals contracting the pelvic floor moving the pelvis forwards and the spine in to a c-curve.
   
   
3. Inhale reaching forwards extending the spine with arms level with the ears. Pull the shoulder blades down towards the hips and draw in the abdominals.
   
   
4. Exhale go through the c-curve back to starting position.
   

HIP AND THIGH OPENER
This exercise is targeting the core, hips thighs which is not only important for vanity reasons but essential for a stable spine to support the baby.

1. Start lying on your side, ear resting on your bicep with both legs bent in front of you. Keep your abdominals engaged and lift the top leg as high as you whilst maintaining stability in the hips.
   
   
2. Concentrate on your core by exhaling and drawing in the abs keeping the hips as steady as you can through out this exercise. Repeat this 10-25 times each side.
   

Current research now shows multiple medical benefits of exercise for the pregnant women and her fetus. I highly recommend the "3 in 1 Pregnancy System" too as a safe workout that will help women feel great when they are pregnant. Merrill Sue Lewin, MD. F.A.C.O.G Huntington Hospital, Pasadena, CA.

Research states that exercise is essential for the health of the soon to be mother and baby, the "3 in 1 Pregnancy System" has great safe exercises to keep the core and especially the pelvic floor muscles strong. I believe regular core stabilization and flexibility training can dramatically decrease complications such as Incontinence after child birth, because of this I recommend the Pregnancy System to patients and friends. Howard Kaufman, MD, Chief of Pelvic Floor Reconstruction, U.S.C. Keck School of Medicine.

As an OB-GYN Nurse Practitioner, I encourage my pregnant patients to be active during their pregnancies, for their own health, and for the health of their baby. The "3 in 1 Pregnancy System" provides an effective and, most importantly, safe workout for women before, during and after pregnancy. Tracey’s instructions and demonstrations of Pilates and Yoga exercise are clear and easy to follow, whether you are new to these routines or experienced in working out with Pilates, as I am. I feel comfortable in recommending the 3 in 1 System to my patients as an excellent addition to their pregnancy care. Pamela Payne, MSN, RNC, OGNP.