Hello, I am a 28 y/o Female. I am 3 weeks late and it has been 51 days since the start of my last menstruation. I began testing for pregnancy with an at home test after being 1 week late. I have taken 4 pregnancy tests since then ( the last test was Friday morning ) and all have been negative. I have been spotting for 9 days off and on, but it is not regular menstruation. Mostly light pink or Brown and I only notice after urination while wiping. I have also experienced nausea, extreme fatigue, Lower back and pelvic pain, mood swings, food and smell sensitivity, and breast tenderness during the first few days the spotting occurred. These symptoms have decreased over the last two weeks however, the last 4 days the spotting has changed to a brighter red with increased lower back pain and headaches. On occasion I have felt a slight sharp lower abdominal pain but it does not linger and there is no further abdominal pain or cramping. Yesterday evening I had extreme back pain and passed a quarter sized chunk of pink tissue in my urine this morning. There was no blood present and it was not similar to uterine shedding that I've had in the past, nor was it similar to a blood clot. Please note I also have a history of women having ectopic pregnancies in my family. I have no access to a family doctor and it is very difficult to be seen at a clinic in my location. Is this something I should be worried about and is there any other symptoms I should watch for before I pursue medical attention? Thank you for your time.