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A Client Handout
By Ivon Dahl

This handout is designed to help you through a healthy term

Note the physiologic changes that accompany your pregnancy
1) First trimester — acute nausea, change in hormone ratios of progesterone (increases) to estrogen; this may cause an overall decrease in your energy levels.
2) Second trimester — blood volume increases (up to 50%), along with incidence of hypo tension (low blood pressure) with exertion; weight gain and increased uterine activity.
3) Third trimester — profound weight gain; increased curve in the lumbar spine is common (affects center of gravity); hormone changes in Oxytocin and Relaxin result in increased uterine activity and joint laxity; cardiac output increases up to 25%; blood hematocrit decreases slightly.

Please follow these guidelines for your Pilates exercise session
· A general goal for Pilates exercise should be to maintain your present level of fitness.
· Regular Pilates is preferred to irregular activity; 3-5 classes per week is recommended
· Appropriate exercise other than Pilates are walking and non weight-bearing activities such as water exercise, or stationary cycling; you may add these options to Pilates days off.
· Durations of 15 to 30 minutes of Pilates are appropriate; rest periodically, long durations can result in thermal stress and reduced oxygen supply to the fetus.
· Moderate your own intensity around 5 on the 1 to 10 scale; exercise within your tolerance.
· Monitor your heart rate, especially during times that you feel are of highest intensity.
· Drink water before, during and after the Pilates exercise class.
· As the pregnancy progresses, a transition from weight-bearing (Pilates Mat-work) to non weight-bearing activity (Reformer) is recommended.
· Gradual increases in intensity during the second trimester are acceptable, as exercise risks tend to be low during this stage, but DON’T stretch past what was your normal range.
· Give feed-back to your Pilates instructor; when positions are uncomfortable, when things get too intense or if you need to be excused (restroom or water break).
· Have fun; emotional changes occur frequently; be pro-active.

Contraindications (NO-NOS)
· Exercise without physician’s consent.
· Athletic competition.
· Exercising out doors in hot, humid weather, PFC regulates the room temperature).
· Ballistic movements such as Reformer-jump board exercises (jerky, bouncing motions).
· Hyper-flexion & hyper-extension, due to laxity in joint connective tissue (Limit your ROM).
· Quick movements; changing directions may result in dizziness, fainting or injury.
· Supine (lying on the back) exercises after the fourth month.
· Exercise requiring a high degree of balance, especially in the second and third trimester.
· Holding of breath (Valsalva maneuver) during exercise.
· Exercise if excessively obese or extremely underweight (without physician’s consent).
· Beginning a new strenuous program during the first or third trimesters.
· Increases in intensity and duration during the third trimester.

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