Painful urination and the possibility of a miscarriage

Patient : I'm on the birth control pill and I missed the 7 day break for the first pack because I was late taking one of the pills, I've just finished the second pack and am on the break. I've had light spotting for about 2-3 weeks now, it hurts sometimes when I urinate and just before see, I looked online and it says something about stis but me and my partner have none. Yesterday was the start of the breakthrough bleeding, in the evening I went to the toilet and there was what looked like a dark red sack of tissue or skin or something, I could see tiny red veins, before this I had really bad cramps which I never get. About half an hour later I went to the toilet and the same thing happened but the tissue was a lot smaller, the first was about the size of my palm. I did some research and it said about miscarriage, I looked at the symptoms and it's seems so, I've got spotting bright red blood cramps etc. Please can you help me to understand what's going on. It also hurts when i urinate and before sex, it cant be an std because my partner and i are clear
Symptoms:  Bright red bleeding (spotting and breakthrough), fatigue, bad cramps, painful urination amd pain before sex
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