Hi Leah, I did a perinatal certification recently, and the director of the workshop said that when you lay at a supine angle on the jump board or another angled prop, it only relieves 60% of the danger to the artery being blocked. She recommends after 20 weeks to not lay on the back at all, even if you're propped up due to this percentage. Have you ever heard this in your experience with pre-natal cautions?

Lisa and Emily - I am very happy that you both enjoyed this class

Colleen,

My apologies for my delayed response. Thank you so much for your comment and question. No, I have not heard of that specific statistic regarding lying supine on an angle. I would love to see that research, as we have so much more to learn about prenatal exercise, and research is often scarce, weak, lacking objectivity or is too qualitative versus quantitative, so any sound research or evidence is so needed and welcomed.

It has been my experience and opinion through practice, teaching and education, that lying supine after 20 weeks (particularly when modified with a prop that lifts the client up at an angle) for short bouts of time - KEY FACTOR! (under 10 minutes) will not cause any adverse effects in pregnant women.

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In saying that though, lying supine for short periods, even propped up on an angle, may not be the preference of every pregnant women depending on how she is progressing through her pregnancy, how she is carrying, her weight gain, her comfort level, and many other factors and variables (some women just do not like or feel good in that position, but some don't mind it or even enjoy it). I say this to emphasis that as professionals we need to make adjustments and be flexible to best meet the needs of our specific client.

As Pilates professionals, we have a variety of considerations and guidelines to factor into our Pilates exercises choices when working with prenatal women in order to keep them and their baby healthy and safe.

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Although I would never advocate that those considerations be taken lightly or ignored, I would also encourage Pilates professionals to not let those considerations create a sense of fear, rigidity or absolutes that may deny particular prenatal clients of performing modified exercises or ranges of motion that are advantageous for them, their body, their pregnancy, their labor and their recovery. The truth is, we are always learning as a whole Pilates community, and considerations and former opinions shift with on going research, experience and feedback from clients. And almost always, there is a safe and wonderful modification so prenatal clients can still reap the benefits of practicing certain exercises.

Yes, after 20 weeks, lying in a flat supine position is no longer recommended, although some women may still feel comfortable in that position for short periods of time. And some may want to stay away from that position long before the 20 week recommendation.

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In this particular prenatal Reformer class I perform the modified Footwork, propped up on the Spring Board, for about 6 minutes, and in another prenatal class here on PA I spend about 4 minutes performing Footwork in the same modified, supine position. In both instances, I mention that although this position is safe, it may not be preferred by every woman. If a supine position (even one modified with a prop) is not comfortable for a woman or if she is having trouble with it, she will feel a slight shortness of breath, perhaps a slight heavy or dizzy feeling. Naturally, this is a sign to stop and switch positions. The good news is that she will "feel" the effects of this position, if it is not right for her, long before any sort of blood and oxygen exchange and flow between her and her baby is compromised. Her body will communicate with her.

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This is why it is so important to keep the lines of communication open between professional and client, keep the session focused and for both parties to be very aware. The advantages of performing this modified Footwork in a modified, supine position are wonderful; the client will feel a great opening of the pelvis as well as pelvic floor activation, a beautiful lengthening of the spine, strengthening of the legs and safe support, utilization and strength maintenance of the abdominals and other trunk stabilizing musculature.

Again, this modified version is not for every woman in every phase of her pregnancy. I've had clients that love to perform this Footwork up until the day they deliver and others that omit it in their late second trimester, it is truly individual.

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But, in my experience, research and practice, I have never found these short periods (this is key in any supine position) of modified supine work to be problematic. Observing, listening and responding with compassion, understanding and creativity to find what works best for each woman is of the utmost importance.

I always tell professionals, at the end of the day, if you do not feel comfortable teaching something (even if you've been told you can) then don't. You, as the professional, must feel confident in your decisions, exercise choices, ability to cue and ability to provide sound anatomical and physiological explanations for your choices. If any of that is missing, then there are plenty of various versions and modifications of any specific exercise for you to teach, or seek more information, so you feel more confident with that particular exercise/s.

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In saying that, in two of my other prenatal Reformer classes here on PA, you will find two other versions or modifications of the Reformer Footwork; one sitting up against the ball and the other sitting on the Long Box. These are great for late 2nd and 3rd trimester clients and offer a slightly different focus, feeling, purpose, objective and outcome. All three versions of the Reformer Footwork that I teach here on PA complement one another, and all three are safe and have been enjoyed by many a pregnant woman

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Colleen, I hope this answers your question and sheds a little more light on the topic. I am always fascinated by research and would love to see more being done with prenatal Pilates, but even research is not the end-all, as research has many variables, subjectivity, limitations and human errors that sway results. But, research gives us an important piece of the puzzle (another important piece is experiences and feedback from clients), providing us with a set of valuable information from which we can create guidelines so we can adapt to meet the certain needs and goals of our clients.

Please let me know if you have any other thoughts or questions, I am always happy to discuss pre and post-natal Pilates - Anytime!

Take care,

Leah