A simple inflatable ball is one of the most useful pieces of pregnancy equipment you can own. It gives you a seat that keeps the pelvis mobile instead of slumped, a support to lean on when the back aches, a prop for squats when your balance is not what it was, and — in the final weeks — a comfortable way to move through early labour. Pilates with a ball during pregnancy is not about intensity; it is about keeping the pelvis, hips and spine moving well, coordinating breath with the pelvic floor, and maintaining strength in the legs and back that carry the growing load. Here is how to choose the ball, what to do on it, and what changes as the trimesters progress.
Key takeaway: Pilates ball exercises are safe for most pregnancies and useful in every trimester. Size the ball so your hips sit just above your knees, use anti-burst, and hold something for balance later on. Focus on seated pelvic tilts, hip circles, marching, wall squats, ball-supported cat-cow and pelvic floor breathing. Avoid lying flat after 16–20 weeks, crunches, deep twists, breath-holding and end-range stretching.
The best Pilates ball exercises for pregnancy are seated pelvic tilts, seated hip circles and figure-eights, seated marching, wall squats with the ball between your back and the wall, ball-supported cat-cow, kneeling forward lean over the ball, seated side reach, and gentle bouncing paired with pelvic floor breathing. Choose a ball that puts your hips slightly above your knees when seated, use a non-slip surface, and keep every movement slow and within a comfortable range. Sophie Mercer, PMA-certified clinical Pilates instructor, designed a 6-week Pregnancy (Second Trimester) protocol of 24 exercises that uses these ball-supported patterns safely.
Choosing and sizing the ball
Sit on the ball with feet flat: your hips should be level with or slightly above your knees, with thighs sloping gently down. As a guide, 55 cm suits heights up to about 165 cm, 65 cm for 165–180 cm, and 75 cm above that — but inflation matters as much as diameter, so pump it firm enough that you do not sink. Buy an anti-burst ball rated well above your weight, use it on carpet or a mat, and keep it away from radiators and sharp edges. From the third trimester, position it near a wall, sofa or sturdy chair so you have something to hold as you sit down and stand up.
Is it safe? A quick check before you start
For an uncomplicated pregnancy, yes. Speak to your midwife or obstetric team first if you have bleeding, placenta praevia, pre-eclampsia, a cervical stitch, severe pelvic girdle pain, or have been advised to limit activity. Stop and seek advice if you experience bleeding, fluid loss, regular contractions before term, dizziness, chest pain, calf pain or swelling, reduced fetal movement, or pain that does not settle. Is Pilates safe during pregnancy? covers the general safety picture in more depth.
8 Pilates ball exercises for pregnancy
Start with 10 minutes and build to 20. Breathe continuously; the exhale is where the pelvic floor gently lifts and the deep abdominals softly support.
- Seated pelvic tilts. Sit tall, feet flat and wide. Exhale and tuck the tailbone under, rolling the ball slightly forward; inhale and tip the pelvis the other way, arching gently. 10–12 slow rounds. Eases lower back ache and teaches pelvic awareness for labour. Keep the range small and painless.
- Seated hip circles and figure-eights. Circle the hips slowly one way for 8, then the other, then trace figure-eights. Mobilises the sacroiliac joints and hips and is lovely in late pregnancy. Move from the pelvis, not the shoulders.
- Seated marching. Sit tall, exhale, lift the pelvic floor, and float one foot an inch off the floor; lower and swap. 8–10 each side. Trains balance and deep core without loading the abdominal wall. Hold a chair if you wobble.
- Wall squat with the ball. Place the ball between your lower back and a wall, feet hip-width and a step forward. Exhale and slide down to a comfortable depth, no deeper than knees at 90 degrees; inhale to rise. 8–10. Strengthens the legs and glutes that carry you through pregnancy and labour. Keep knees tracking over toes.
- Ball-supported cat-cow. Kneel behind the ball with hands resting on top. Exhale and round the spine, drawing the baby gently towards you; inhale and lengthen to neutral or a small arch. 8–10 rounds. Relieves back tension; the ball takes the wrist load out.
- Kneeling forward lean. Kneel on a cushion, drape your chest and arms over the ball, and rock gently side to side while breathing into the back ribs. 1–2 minutes. A restful position for the back and pelvic floor, and a favourite for early labour.
- Seated side reach. Sit tall, one hand on the ball, and reach the other arm up and over on an exhale, lengthening the waist and ribs away from the baby. 5 each side. Creates breathing room in the third trimester.
- Gentle bouncing with pelvic floor breathing. Sit tall and bounce lightly. Inhale and let the pelvic floor soften; exhale and lift it gently. 1–2 minutes. Trains the release-and-lift the pelvic floor needs for birth and recovery; see pelvic floor exercises during pregnancy for the full routine.
Trimester notes
- First trimester: everything above is fine if you feel well. Fatigue and nausea may limit you; short, frequent sessions are better than none.
- Second trimester: usually the most comfortable period. Add the wall squats and marching, work on posture as the centre of gravity shifts, and address any pelvic girdle or SI joint discomfort early — SI joint pain exercises adapts well with the ball for support. Avoid lying flat on your back for long from around 16–20 weeks; the ball replaces most supine work.
- Third trimester: keep the ball near a wall, reduce squat depth, favour the seated and kneeling positions, and spend more time on hip circles, forward lean and breathing. Bouncing and circles in the final weeks are comfortable and may help the baby settle into a good position, though they do not induce labour.
What Pilates moves to avoid while pregnant
Crunches, sit-ups, roll-ups and the hundred; prolonged lying on your back after mid-pregnancy; face-down positions; deep twists across the belly; breath-holding; end-range stretching (relaxin makes joints looser than they feel); long planks and unsupported single-leg balances late on; and anything that causes pain, pelvic pressure, dizziness or doming down the midline of the belly. If you also attend a studio, reformer Pilates for pregnancy explains how the same rules translate to the machine.
How the Pregnancy (Second Trimester) protocol helps
Sophie’s 6-Week Pilates Program for Pregnancy (Second Trimester) puts these principles into a structured plan — pelvic mobility, posture and leg strength, pelvic floor and breath coordination, and back care — across 24 exercises that work with a ball or simple props at home, with the modifications for the growing belly already built in. It is designed to keep you moving well through the middle of pregnancy and to set up an easier postnatal recovery.
This article is for informational purposes only and does not constitute medical advice. Every pregnancy is different; please check with your midwife, obstetrician or a pelvic health physiotherapist before starting or changing an exercise programme, and stop and seek advice immediately if you experience bleeding, fluid loss, contractions, dizziness, chest pain, calf pain or reduced fetal movement.