Postnatal Pilates Exercises: A Safe Return After Birth

The best postnatal Pilates exercises are small ones: slow breathing, gentle pelvic floor work, pelvic tilts and supported bridges. You can begin them early, as long as nothing hurts and your healthcare provider has no concern. Intensity comes later, once your body shows it is ready. This guide explains what to do first, how to build from there, which symptoms mean you should step back, and what Pilates can offer that a video at home cannot.

TL;DR

• Start with walking, breathing and pelvic floor exercises. Add Pilates movement as incisions or tears heal and bleeding does not increase with activity.
• The 2025 Canadian guideline suggests pelvic floor muscle training every day and 120 minutes of moderate-to-vigorous activity a week, spread over at least four days, when you are cleared for it.
• Heaviness in the perineum, pain, or leaking urine, gas or stool during an exercise means you should regress it and see a perineal and pelvic floor physiotherapist.
• Private or duo sessions let an instructor adapt every exercise to your birth, your recovery and your day-to-day energy.

Table of Contents

• When can you start Pilates after birth?
• Check your readiness first
• Postnatal Pilates exercises to start with
• What about diastasis recti and a C-section?
• How to build a routine
• Signs to stop or modify
• Why a studio can help
• Our perspective
• Postnatal Pilates at MTLPILATES
• FAQ
• Sources

When can you start Pilates after birth?

There is no single date. Québec’s public health institute says you can resume physical activity gradually as soon as possible after delivery when you have no contraindications, beginning with light activity such as walking or pelvic floor exercises. You then increase intensity once incisions or tears have healed enough and lochia (postpartum bleeding) does not increase with light activity. The same page says moderate- to high-intensity activity should be resumed within the first 12 weeks.

The 2025 Canadian Postpartum Physical Activity Guideline says the same thing in clinical language: begin with early mobilization at light intensity, and progress once surgical incisions or perineal tears have sufficiently healed and bleeding does not increase.

CHU Sainte-Justine adds a useful order of operations. You can walk as soon as you feel ready, and you should prioritize abdominal and pelvic floor muscle exercises before going back to high-impact activities such as running or heavy lifting. CHUM also notes that the right timing for sport depends on you and on your fitness before pregnancy. Someone who trained five days a week and someone who stopped exercising in the first trimester will not progress at the same pace, and neither is behind.

So “how soon” really has two answers. Breathing and gentle pelvic floor work can start in the first days. A full Reformer class, with spring resistance and sustained abdominal work, belongs later, after you have checked in with your provider and your body is giving clear signals.

Check your readiness first

The 2025 Canadian guideline introduces the Get Active Questionnaire for Postpartum, a short self-administered tool that helps you see whether you need guidance from a healthcare provider before returning to moderate-to-vigorous activity. Fill it in before your first session with any instructor, and bring the result to your postpartum checkup.

The guideline also points parents to two kinds of professional: a primary healthcare provider for advice on moderate-to-vigorous activity, and a pelvic floor physiotherapist for instruction in pelvic floor muscle training. In Montréal that is a sensible pair to have before you walk into a Pilates studio.

If your recovery is complicated by a medical condition that changes how you move, the principle of checking readiness and asking for medical guidance first applies even more. Trainers who want to understand how that thinking works across conditions can read this guide to cerebral palsy exercise for trainers.

Postnatal Pilates exercises to start with

The sequence below follows the logic most pelvic health professionals use: breath first, then pelvic floor, then the deep abdominals, then load. Keep every movement small, slow and pain-free. Stop if anything on the warning list further down appears.

1. Diaphragmatic breathing in crook lying

Lie on your back with knees bent and feet flat. Place your hands on your lower ribs and breathe in so the ribs widen sideways. As you exhale, let the ribs soften down and feel the deep abdominal muscles gently draw in. Physiotherapy guidelines from NHS Lothian describe deep diaphragmatic breathing in this position as the way to enable a deep abdominal contraction on the exhale.

This is the base of the Pilates method, and it is the exercise most people rush. Give it five to ten calm breaths, not a count to hit.

2. Pelvic floor awareness

On the exhale, imagine lifting and closing the pelvic floor, then release fully on the inhale. The release matters as much as the lift. It can be hard at first: the same Lothian guidelines note that starting a pelvic floor contraction after a vaginal birth is often very difficult. If you feel nothing, that is common and not a failure. A pelvic floor physiotherapist can confirm that you are doing it correctly.

The Canadian guideline recommends that postpartum people do pelvic floor muscle training daily to rehabilitate the muscles and reduce the risk of urinary incontinence.

3. Pelvic tilts

Still in crook lying, exhale and gently tilt the pelvis so the lower back softens toward the mat, then inhale back to neutral. The movement is a few centimetres, not a big curl. It wakes up the lower abdominals and teaches you to separate pelvis from ribs, which many new parents lose after months of carrying and feeding.

4. Heel slides

Exhale and slide one heel away along the mat, keeping the pelvis still and the ribs soft. Return on the inhale. If the belly pushes out or you feel pulling along the midline, shorten the range. Heel slides teach the trunk to stay stable while a leg moves, which is the pattern you need for lifting a car seat or climbing stairs with a stroller.

5. Small bridges

Exhale, roll the tailbone up and lift only as far as you can without the ribs flaring. Lower one vertebra at a time. Bridges rebuild glutes and hamstrings, and they prepare the spine for the Reformer footwork you will meet later.

6. Modified dead bug and arm reaches

With knees bent over the hips, or one foot at a time on the floor, reach the arms overhead on the inhale and return on the exhale. Add one leg at a time only when the arm version feels easy and nothing bulges or aches along the midline.

7. Thoracic mobility and posture

Feeding, carrying and bending over a crib round the upper back. Gentle side-lying rotations (open book) and seated spine extensions restore movement through the mid-back. Good alignment in sitting and standing also supports optimal muscle activation, so check how you sit during night feeds. Our page on Pilates for posture in downtown Montréal goes further on this.

What about diastasis recti and a C-section?

Diastasis recti is a widening of the gap between the two halves of the rectus abdominis. Plenty of people have some separation after birth, and the work above, breathing, deep abdominal engagement and small controlled movements, is the foundation of how Pilates approaches it. The practical rules are the same ones as for any core exercise: keep the range small, exhale on effort, and drop any movement that makes the belly dome or cone along the midline.

After a C-section, you are recovering from abdominal surgery as well as from pregnancy. The guidance above applies directly: progress only once the incision has sufficiently healed and bleeding does not increase with activity. Walking and breathing come first. Ask your surgeon or provider when you can add abdominal loading, and tell your instructor about the scar before the first session so they can choose positions that do not drag on it.

How to build a routine

When you have been cleared for moderate-to-vigorous activity, the Canadian guideline advises aiming for 120 minutes a week, spread over at least four days, and notes clinical benefits such as fewer depressive symptoms. That target is a destination, not a first-week assignment. Here is one way to get there.

Short and frequent beats long and rare. Ten minutes on the floor while the baby naps counts. If a week goes badly because of sleep, repeat the previous week rather than pushing on.

Signs to stop or modify

CHUM and CHU Sainte-Justine both stress that heaviness in the perineum, pain, or leakage of urine, gas or stool during exercise means you should regress the progression and consult a perineal and pelvic floor physiotherapist.

In practice:

• If an exercise causes heaviness or pressure downward, go back to the previous version and breathe out earlier in the movement.
• If you leak, even a little, treat it as information. It is common, and it is treatable, but it is not something to push through.
• If bleeding increases after activity, rest and let your provider know.
• If you see doming along the midline of the belly, reduce the range or change position.

A good instructor will watch for these signs and change the exercise before you have to ask.

Why a studio can help

Videos are fine for the breathing and pelvic tilt basics. They cannot see your ribs flare, your pelvis tuck, or the moment you hold your breath. Hands-on correction is the difference between an exercise that rebuilds control and one that quietly reinforces a compensation.

The Reformer is also a gentle tool when it is used well. The springs can assist as well as resist, and the carriage lets you work lying down, which takes pressure off a tired pelvic floor. On the Cadillac, Wunda Chair and Ladder Barrel, an instructor can find positions that suit a healing abdomen. If you want to see how the equipment is used, our pages on the Reformer and on the full apparatus explain each piece.

Our perspective

We work with a lot of people in the months after birth, and the pattern is consistent. They arrive motivated, a little impatient, and often unsure what their body can handle. Our first job is to slow things down. A postnatal client does not need a harder class. She needs her breath, her pelvic floor and her trunk to work together again, and that takes private attention.

That is why we usually recommend private or duo sessions at the start, then a move into small group classes. Our therapeutic work is the heart of the studio: many clients arrive referred by their physiotherapist or doctor, and we build on that guidance rather than replace it. We are not a sculpt studio and we do not teach hybrid workouts. Every instructor is certified across the full system, does continuing education each year and carries their own insurance. We teach Pilates as Joseph Pilates intended, adapted to the body in front of us.

— Véronique Lefort

Postnatal Pilates at MTLPILATES

Our prenatal and postnatal Pilates work happens in private and duo sessions, where we adapt each exercise to your birth, your recovery and your goals. Private sessions are $100 to $130 and duo sessions are $120, and all private options are listed here. Insurance receipts are available on request for private lessons and duos, so you can check what your plan covers. Classes are taught in English and French.

When you are ready for groups, our Reformer Foundations and All-Level classes are $33 per class, capped at 12 people on the Reformer and 50 minutes long. If you are new to the studio, our guide to your first Pilates class explains what to expect. For a broader view of our injury and recovery work, see Pilates for rehabilitation in Montréal.

FAQ

How soon after birth can you do Pilates?

Gentle breathing and pelvic floor exercises can begin in the first days if you have no contraindications. Pilates movement on the mat can follow once incisions or tears have healed enough and bleeding does not increase with activity. Moderate- to high-intensity activity should be resumed within the first 12 weeks, per Québec’s public health institute. Confirm your own timing with your provider.

Can Pilates help with diastasis recti and pelvic floor problems?

Pilates teaches the breathing, deep abdominal control and alignment that recovery relies on, and a good instructor keeps the range small and monitors the midline. It does not replace assessment. If you have heaviness, pain or leaking, see a pelvic floor physiotherapist and share their guidance with your instructor.

How often should I do postnatal Pilates?

Pelvic floor exercises are recommended daily. For a full routine, the Canadian guideline aims for 120 minutes of moderate-to-vigorous activity a week across at least four days, once you are cleared. Begin with two or three short sessions and build from there.

Do I need private sessions or can I join a group class?

Private or duo sessions are the better start, since the instructor can tailor each exercise to your recovery. Once you have control of your breath, pelvic floor and trunk, a small group class like our Reformer Foundations is a natural next step.

Sources

• Resuming physical activity after childbirth, INSPQ
• 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour and Sleep throughout the First Year Postpartum, CSEP
• La reprise de l’activité physique en post-partum, CHU Sainte-Justine
• Taking care of yourself in the weeks following childbirth, CHUM
• Diastasis Rectus Abdominis guidelines, NHS Lothian Physiotherapy

Recommended

• Prenatal & Postnatal Pilates in Montreal