How a Physiotherapist Screens Prenatal Clients for Safe Pilates

PhysioMatters
Jul 4
3 min read

Not all exercise during pregnancy is a one-size-fits-all. While Clinical prenatal Pilates is often a safe and effective way to stay active, it’s most beneficial when exercises are adapted to your trimester, symptoms, and health status.

As Physiotherapists, our role is to create and adapt a Pilates program that supports both you and your baby, starting with a thorough, evidence-informed assessment.

Why Screening Matters?

Most pregnant women benefit from movement but we want to be sure it’s the right kind of movement for you and your pregnancy.

Our screening helps us:

Identify any red flags requiring referral (high concern areas)
Understand your obstetric and musculoskeletal history
Design sessions that suit your body’s current needs

It’s not about restricting your exercises, it’s about choosing the best type for your body.

Related Topic: Check out our article here on "Why Choose a Clinical Physiotherapist for Prenatal Pilates in Singapore?".

Step 1: Medical & Obstetric Screening

We start with a detailed health history to rule out contraindications to prenatal exercise.

Clinical Red Flags (Require Medical Clearance)

Placenta previa after 26 weeks
Unexplained vaginal bleeding or fluid loss
Persistent abdominal discomfort or contractions
Pre-eclampsia or gestational hypertension
Uncontrolled gestational diabetes
Cervical insufficiency or cerclage
Risk of preterm labour
Multiple gestation with complications

In the presence of any of these, we will work closely with your doctor before proceeding.

Step 2: Functional & Musculoskeletal Assessment

We look at how your body is moving and adapting:

✔️ Postural alignment (e.g. spinal curves, pelvic position)

✔️ Pelvic girdle comfort (e.g. SIJ or pubic joint sensitivity)

✔️ Spinal mobility and core control

✔️ Gluteal and abdominal coordination

✔️ Diaphragmatic breathing pattern

✔️ Balance, proprioception, and movement confidence

This allows us to choose Pilates exercises and positions that support you, whether that’s on the reformer, mat, or using props.

Step 3: Pelvic Floor Considerations

Pelvic floor screening includes:

Any symptoms of heaviness, leakage, or urgency
Your awareness of engagement and release
History of incontinence, prolapse, or birth-related trauma
Use of real time ultrasound imagery, as a biofeedback tool to ensure you engage the pelvic floor correctly

This will guide us on how we cue breath work, core connection, and relaxation.

Step 4: Clinical Reasoning for Pilates Programming

Based on all findings, your Pilates plan is tailored to your trimester:

Early pregnancy: breath awareness, gentle strengthening, and posture control

Mid-pregnancy: load management, gluteal / core activation, and spinal support

Late pregnancy: pelvic mobility, movement confidence, and birth preparation

For exercises traditionally done in a flat lying (supine) position, we use a pregnancy wedge or elevate the torso from 20 weeks onward. This position promotes circulation, reduces pressure on major vessels, and maintains comfort throughout your session.

We always prioritise quality and adjust your exercises based on how you feel that day - because pregnancy changes week to week, and your movement plan should too.

Final Thoughts: It’s More Than Just a Checklist

Physiotherapists combine clinical reasoning, movement analysis, and pregnancy-specific knowledge to ensure every session is safe, effective, and meaningful.

Move with Confidence at PhysioMatters

At PhysioMatters, our Women’s Health Physiotherapists are trained in prenatal care and Clinical Pilates. Whether you're new to exercise or staying active through pregnancy, we'll help you move safely and purposefully.

Book a prenatal assessment with us today and let’s support your pregnancy journey with fun and effective movement.

Related Topic: Check out our article here on "What to Expect in Your First Prenatal Pilates Session with a Clinical Physiotherapist in Singapore?"

Cheers

Danielle, Xan, Claire - Physiomatters