Just because you have bleeding doesn't mean go to the ER. Perhaps if it's Friday night and your ob won't be in until Monday and you are doubled over with cramps that don't feel right, then go. It could be ectopic then. Perhaps you are nine months along and giving birth, then go.  But just for some bleeding or spotting? No. Stay home, take it easy, monitor it, and call your doctor as soon as you can. ER docs are doctors but they are not specialists in female reproductive care. Half the testimonials I read say that what the ER doc told them was completely wrong anyway. No the woman did not miscarry and 2 days later at the ob, she sees her baby and hears a heartbeat and all is fine. Go to the ER when you have an emergency- they specialize is saving life, limb, and sight. Not giving you an ultrasound because you had spotting on your panties and your ob is closed for 8 more hours. If you are having a natural miscarriage, neither the ER doc, nor you, nor your ob can do anything to stop it. Ease up on the recommendations to go to the ER people. Don't clog up the ER and the healthcare system with non-emergencies. By the way, you will likely have to wait for hours while they treat real emergencies ahead of you and in the end you'll get a nice big bill for your ER visit.