The key finding
A systematic review published in 2025 analyzed 10 studies involving 499 pregnant women and found that Pilates practice during pregnancy was associated with measurable improvements in quality of life. Among the 268 women who practiced Pilates, two studies showed statistically significant improvements in perceived quality of life (p = 0.018) and sleep quality (p = 0.018) compared to 231 women receiving routine care. Eight of the ten studies reported reductions in lower back and pelvic pain (p < 0.001 and p < 0.05), while mental health benefits included decreased anxiety in two studies (p < 0.05 and p = 0.009) and reduced depression scores in one study, where the Pilates group’s average score dropped from 8.61 to 4.59.
What the study looked like
This systematic review followed PRISMA 2020 guidelines and searched four major databases (PubMed, Scopus, Web of Science, and Trip Database) for studies published between January 2013 and February 2024. The researchers identified 10 publications that met their criteria, collectively involving 499 pregnant women. Of these participants, 268 had engaged in Pilates practice during pregnancy while 231 received standard prenatal care as a control group. The review examined outcomes including perceived quality of life, pain levels (particularly lower back and pelvic pain), sleep quality, physical mobility, and mental health indicators such as anxiety and depression. Methodological quality of included studies was assessed using the Joanna Briggs Institute’s critical appraisal tool to ensure reliable findings.
Why researchers think this happened
The authors suggest that Pilates’ focus on core strengthening, controlled breathing, and mindful movement may address several pregnancy-related challenges simultaneously. The method’s emphasis on pelvic floor and deep abdominal muscle engagement likely contributes to reduced lower back and pelvic pain by providing better support for the changing body during pregnancy. Improved sleep quality may stem from reduced physical discomfort and the stress-reduction aspects of the practice. The mental health benefits—particularly reduced anxiety and depression—could be linked to both the physical relief from pain and the mindfulness components inherent in Pilates practice. The review notes that supervised physical activity led by nurses and midwives may enhance pregnant women’s perception of their own health, suggesting that professional guidance and structured exercise together create a supportive environment for physical and psychological well-being.
How to read this carefully
While the findings are promising, this review has important limitations. The total sample size of 499 women across 10 studies is relatively modest, and not all outcomes showed consistent benefits across studies—one study reported no significant differences in pain levels. The review combined studies with different Pilates protocols, frequencies, and durations, making it difficult to determine an optimal approach. Most importantly, this is a systematic review of observational and intervention studies, not a single large randomized controlled trial, so the strength of evidence varies across included studies. Women who chose to participate in Pilates programs may have differed from control groups in motivation or baseline health, introducing potential bias. The review doesn’t establish that Pilates causes these improvements—only that the practice is associated with them in this population.
What this means for everyday life
For pregnant women considering exercise options, these findings suggest that Pilates might be worth exploring as part of prenatal care, particularly if you’re experiencing back pain, sleep difficulties, or anxiety. The strongest evidence emerged for pain reduction, which affected eight of the ten studies reviewed. Given that the research emphasized supervision by healthcare professionals like nurses and midwives, seeking a qualified instructor experienced in prenatal modifications would be important. This isn’t about Pilates being a cure-all, but rather one potentially helpful tool among many for managing the physical and emotional challenges of pregnancy. If you’re pregnant and interested, discussing Pilates with your healthcare provider can help you determine whether it’s appropriate for your specific situation and how to incorporate it safely into your prenatal routine.