RPM Physiotherapy

The Expectant Mom Project: Preparing to Labour and Recovering Post Delivery with Pilates

Toronto is a city of convenience. Between our busy lives, challenging transit and strong community loyalties, it is rare that Torontonians venture more than a five kilometer radius from home or work to use a business or service. The Loft Pilates is an exception and that is largely due to their reputation as one of the premier, if not the best, Pilates studio in the city. I first learned of Myriam Pelletier and her team while working in midtown. Patients were breaking their normal 5km rule and braving traffic to benefit from their expertise.

Fast forward 2 years and I had the serendipitous good fortune to open my office across the street and the opportunity to interact with Myriam. Her attention to detail and ability to connect mind and body is unparalleled. I have yet to have a conversation with her where I don’t walk away feeling more knowledgeable, having had a great laugh and generally a happier person. She extends these high standards of teaching and warmth to her business and staff so I was naturally excited to meet with Riikka, at Myriam’s recommendation, to discuss her pre and postnatal work.

Riikka and I share some mutual clients and I had already heard about her exceptional work with women struggling post pregnancy. She is in person as lovely as her client’s testimonials. Her expertise is woven from a beautiful blend of scientific study and personal struggle and success. I am so pleased to be able to offer her wisdom as the first official installment of The Expectant Mom Project. I hope you enjoy her interview as much as I enjoyed her conversation.

How did you become passionate and involved with pre and postnatal Pilates?

I have always loved pregnancy, delivery and children but it truly was my own journey that brought the sense of depth and meaning to my work. For all three of my children, I loved being pregnant and I loved delivery. My first child weighed a hefty 9 pounds, 12 ounces. The training I had in fitness and anatomy prepared me for my pregnancy but my post-natal recovery felt very foreign. This was 2008 and reasearch was just being done in this area so I knew I wasn’t the only woman to feel this. It gave my work a sense of direction.

I was a postnatal wreck and I didn’t recognize my body: I had a hernia and major diastasis recti of six and a half finger widths that left me feeling gutted; at times I could not stand up because I was so weak; I had major sacroiliac seizing and I started to wonder what happened. Nothing I had studied seemed to apply to my condition.

I dove into research, learning as much as possible about the pelvic floor, pelvic health and deep core system. I learned a ton from my internal pelvic health physio and discovered what was going on with my body. I was hooked.

Four years (and several courses, lectures, sweat, tears and laughs) later I got pregnant with my third. Everything I had learned I applied to myself. It was such an easy pregnancy and the postnatal recovery was two months versus two years. I recognized that body, I recognized how I felt and I recognized what I was supposed to do.

I am passionate about working with prenatal and postnatal women because I feel what they are experiencing. I feel their frustration, their happiness, their sadness and their succes. It is very rewarding to witness a client connecting with their inner strength for the first time in a very long time.


What would your pro-active approach be in terms of teaching? Where do you focus your attention?

With my prenatal women a lot of my work is about how to deliver. It is not necessarily about strengthening Pilates, although we do strengthen, but rather the mind body connection. It is about where you deliver, how you deliver, how to release into the delivery and who to believe and trust when you are in this new situation. Many first time moms are stuck with the “textbook”. At the end of the day, how many lines and bullet points do you remember when you are in delivery? You are there by yourself and hopefully another person supporting you, but that’s it. You have to find the strength and the answers and the confidence within you. I try to coach my women to reconnect with what brings them safety. If the body is not in its comfort zone, how can it kick on those natural responses that can be available? In my prenatal classes this is exactly what we connect to and become aware of and then learn when and how to use them.


The first time I gave birth, I wanted to do it naturally. I remember the moment the nurse looked me straight in the eye and said “you are delivering a huge baby and this is just three hours into it. You’re going to have a long time until it comes out, are you sure you don’t want any medication?” It switched something in me: what is the most important thing here? Was it that I hang onto some kind of an idea of what I wanted to do, or that I can be conscious and meet my son and I can be alert at that moment. I knew I had to rest and collect all that I had to push that giant baby out of me. You just need to learn to switch the gears in a way that it’s not always in the readings.

Postnatally, it is important to recognize the value of an internal pelvic health physio. The true recovery really starts from inside out. The latest research shows that the first 8 weeks post-delivery is the time when you can really manipulate the tissue. I don’t mean to do crunches, or go for a walk. I give my prenatal women exact steps for what is safe in the first 8 weeks. It is mostly breathing. It is mostly getting your senses back into your pelvis, which has been torn and occupied for 9 months. Physiologically, this neuromuscular repatterning wires the nerve endings that were broken, torn, and stretched from the brain back into the tissue and starts the healing process. A lot of women are so eager to lose the baby weight and rush back into running or boot camps. It is so crucial for them to slow down at this early stage of healing. I see same patterns in pelvis whether the client is 80, 50 or just delivered if the healing process has been rushed.

What physical components do you coach for labour and delivery to try and prepare your clients for it (positioning, breath, etc.)?

The number one goal as their prenatal instructor is to help women find their inner tools. Tools that they have within themselves and that they know when and how to use them. We work a lot with breath; the direction of the breath, and the direction of force for delivery. I was coached by the nurses to push towards my anus. As I did that my gut said “that’s not where the baby comes out!” So, I changed the direction of my breath and force of direction towards birthing canal and the front of the pelvis. The baby, 9lbs 12oz, was out after only a couple of pushes. I hear this also from my clients over and over again.

Breath goes hand in hand with the pelvic floor. The anatomy of the deep core system is brilliant and when used to its ideal, it can be the best power tool you have for delivery and postnatal recovery. I use a lot of imagery which I’ve learned from several movement methods (such as The Loft Pilates and Franklin Method) and a lot of awareness exercises. Muscularly, I teach women to synchronize their deep core system where we also start the healing process postnatally. We also concentrate a lot of upper body opening exercises to counteract the hours of carrying the baby. Finding the ideal alignment and then building support for it are the building blocks with my postnatal clients.


Does your approach through this whole process change your treatment course based on previous history from past pregnancies?

My approach is very personalized. I look at each client’s history, goals, body alignment and muscular recruiting patterns. I challenge their body awareness and together we make a plan. However, it tends to always come back to pelvis! For example, in my own healing journey from a major diastasis recti really started to fast track when I realized that my anterior pelvic floor is much looser than the posterior pelvic floor therefore making it challenging to connect with the deep frontal abdominal wall. This is a very repetitive pattern that I have noticed with clients. Did anyone tell me that during prepregnancy – NO! So, once again, bringing awareness to people where they need it the most can be a huge missing link.

How do you translate those teachings into lifelong awareness and habits so clients are self-sufficient?

I’ve been working on this a lot with my clients and it truly comes down to training body awareness. As a society we are a forward moving society. Moving forward and fast in a very passive state. Just getting from A to B but not really noticing how we got there. If you train to be aware, to become active while just sitting or holding a baby will add miles to your recovery process. One hour of Pilates per week will not help you to heal but if you can apply the awareness into your everyday activities it will start to add up quickly. If you run with fully aware of your body and support of your deep core system your run will become so much lighter and injury free. If you have sciatica pain but you don’t become aware how you sit by your desk or while holding your baby, it’s hard to maintain all that you can gain from our sessions. Body awareness; mind-body connection is huge with the work that I do.We mimic sitting at the desk, we mimic going up the stairs. We bring it to practical activities like picking up baby – how do you do it without leaking, or how do you laugh without leaking, those kinds of little things. It starts small then starts to build once you have a little bit more confidence to use the strategies that I try to implement.

What is a normal time frame (bearing in mind that everybody is different) for people if they’re trying to make improvements?

It depends on your commitment. Pain is not normal state within our body but it can be a very motivating factor. Some clients have tried every other outlet they have known but still are not seeing results. So, they come with a much more intensity to see and feel the change. If you put in the work, I have had clients (myself included), who have been able to be pain free in a couple of weeks. It is interesting as moms, most of us are so connected to our children and the family, but we are often disconnected from ourselves. If we lose ourself who do we have left to run the circus at home?

So, I give very practical advice to new moms. There is a lot of time when we are feeding or putting the baby to sleep during those first few months. Use those times not just to give, but also to reconnect with yourself. It seems little yet very beneficial. Your neurological repatterning can be done while lying in bed with your baby in your arms. Once people are serious about their commitment and investment into their health, the results will come. I will provide you with what works, and then you need to come and meet me halfway. Together, we will achieve your new self and the confidence you always had.

Interested in working with Riikka? She can be reached at:

Riikka Wilson

Lead Movement therapists / Pre and Postnatal specialist

The Loft Pilates http://www.theloftpilates.com

Riikka@theloftpilates.com 416-604-0177


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