Understanding Early Pregnancy Options & Thyroid Concerns

Question
I am a single parent and I was recently diagnosed with a hyperactive thyroid. I have been on medication for a month or so. I just found out I am 4 weeks. My obgyn says there are some congenital birth defects that could occur from the medication but says it could also be normal. Due to thh fact that I am a single parent in a relationship with someone who isn't going to help because he doesn't now and he isn't supportive. After telling him and his selfish reaction I have decided to end this relationship and I have decided to end the pregnancy. I have had a surgical abortion before, but this one is hard for me. I don't want to do it, but I feel it is necessary. I have been reading way too much online. seems like I could only find the horror stories and religious propaganda
If I ended up with a perforated uterus how would I know? Would it happen during the proceedure or after? Is there a risk for other issues because I have a hyperactive thyroid that is not yet totally undercontrol? My procedure is scheduled for next week i will be 5 1/2 weeks. I am terrified. The clinic reassured me that its safe and that very very few people get a perforated uterus. What are my real chances. please help educate me. I certainly don't want to die because of this choice.I have a little girl at home who depends on me Someday i may meet the right one and decided to have another baby. But not on my own. what kind of quality life could I possibly give a new born and a 5 year old on one income.

Answer
Dear Steph,
It sounds like you are making the right decision for yourself at this time.  
First, there is very little risk of perforation with an early pregnancy.  Usually this would happen with someone who is further along, and who had multiple c-sections.  Even if an extremely unlikely perforation happened for an early pregnancy, it is typically mild and treated like a bruise - the uterus heals very quickly.  Surgical abortion is one of the safest medical procedures and complications are extremely rare.

However, if this still scares you, you are very early in your pregnancy and you are eligible to get a non surgical abortion.  The abortion pill is fairly widely available and is a real option for you.  The Aspiration Procedure is in my opinion the most safe and simple option, and avoids the risks of surgery.  However, it's very difficult to find a doctor who offers it (see earlyabortion.com).  If you do not feel comfortable with the clinic where you have an appointment, we have many women fly in for a day and get our specialized early abortion services in NYC (earlyabortionoptions.com).

I hope this is helpful,
Doctor Joan
EarlyAbortionOptions.com
New York City