Maybe A Miscarriage

So I am on birth control pills, in early August I started spotting randomly. I went to my gyno and they switched me to another pill. The spotting did not stop after 2 weeks, so they switched me to another. They also did blood work and an ultrasound and everything came back normal. I am still spotting and it has been well over a month now. The past couple of days I have had heavy bleeding enough to wear pads and I had some severe cramping yesterday. I usually never cramp on my periods or have any kind of clots. And my usual periods maybe last 3 days. Yesterday I passed a small chunk of something and I am unsure if it could be a possible miscarriage. I am not cramping this morning but still bleeding the same. I am posting a picture just to see what anyone else thinks. I was not trying to get pregnant, but I want to know if this could possibly be a miscarriage. Thanks.