Aims Childbirth training programs together with exercise during pregnancy have drawn attention in many countries. The aim of this study was to investigate the effects on pregnancy and delivery outcomes of clinical Pilates exercises given with or without childbirth training. Methods A total of 64 pregnant women were randomly separated into three subgroups as Group 1, who received childbirth training with clinical Pilates exercises (n = 21), Group 2, who received only childbirth training (n = 21) and Group 3 as a control group (n = 22). The clinical Pilates exercise training was applied 2 days a week for 8 weeks, and childbirth training was applied one day a week for 4 weeks. Demographic data, weight gain throughout the pregnancy and duration of labour were recorded. Pain intensity during labor was evaluated with a Visual Analogue Scale. Anxiety was evaluated with the State-Trait Anxiety Inventory. Birth outcomes were recorded as gestational age at birth, birth weight and APGAR scores. Results Pre-training, the groups were homogenous in terms of demographic characteristics and general anxiety (P > .05). After the training, the Pilates group had better general anxiety values, gained less weight and felt less pain during labor than the other groups (P < .05). No difference was observed between the groups in terms of the duration of labor, gestational age, or infant birth weight (P > .05 for all). The APGAR scores of the infants of the Pilates group were better than those of the other groups (P < .05). Conclusions The study results showed that childbirth training applied with clinical Pilates exercise had a positive effect on pregnant women and their birth outcomes.