I just had a very early miscarriage/chemical pregnancy. I only knew I was pregnant for two days before the bleeding started. Is it true that I have to avoid tampons until my next period even though my pregnancy was so early along? --About.com reader
Doctors traditionally advise against use of tampons during miscarriage bleeding. The reason for this recommendation is that the cervix may be dilated more than in a typical menstrual period, and theoretically, use of tampons during a miscarriage might pose an increased risk of developing a uterine infection or toxic shock syndrome (a potentially fatal type of infection associated with tampon use).
That said, there aren't any studies documenting an increased risk of infection specifically attributable to use of tampons after miscarriage, or providing details for this recommendation. It's possible that the risk might vary in different situations. After a chemical pregnancy, for example, it's likely that any added risk of tampon use would be quite low -- especially considering that most chemical pregnancies probably occur unnoticed. But again, there's no data available.
To err on the side of caution, it's best to follow the traditional advice and choose pads for the miscarriage bleeding. If you feel strongly about using tampons versus pads, discuss the matter with your doctor. Your doctor can help you decide what's best for your situation, and if you do decide to use tampons after a very early miscarriage, your doctor can make sure you are informed of the warning signs of infection and what to do if you might develop symptoms.
Note that whenever a D&C is performed as a part of treatment for a miscarriage, tampons should always be avoided following the procedure due to an elevated risk of infection.
After a Miscarriage: Physical Recovery. American Pregnancy Association. Accessed: Feb 21, 2010. http://www.americanpregnancy.org/pregnancyloss/mcphysicalrecovery.html
Hajjeh, Rana A., Arthur Reingold, Alexis Weil, Kathleen Shutt, Anne Schuchat, and Bradley A. Perkins. "Toxic Shock Syndrome in the United States: Surveillance Update, 1979–1996." Emerging Infectious Diseases 7Vol. 5, No. 6, November–December 1999.
Smith, Mindy A. and Leslie A. Shimp. "20 common problems in women's health care." McGraw-Hill Professional, 2000.