What to expect during a hospital exam
Deciding to seek medical attention after a sexual assault does not mean you have to report the crime. Rape exams can be done on an anonymous basis. However if you are under age 18, the medical staff must report the assault to the police. Going to the hospital is about your health and safety. Treatment may be essential to ensure that there are no physical injuries requiring immediate care. Medication to prevent infections and STDs are offered and emergency contraception is available to those who want it. The hospital staff may ask to perform a sexual assault medical/forensic examination during which forensic evidence may be collected. You have the right to refuse the entire exam or any part of it at any time. An advocate will meet you at the hospital
An Examination Includes:
- Medical-forensic history, for the purpose of diagnosis and treatment.
- Head to toe physical exam, looking for trauma.
- Detailed genital exam, looking for trauma.
- Collection of forensic evidence (evidence that can be used for legal purposes, should you choose to report the crime.)
- You may have internal and/or external injuries that you are not aware of.
- You may have been exposed to a sexually transmitted infection.
- It is possible for you to become pregnant as a result of the assault.
- The collection and documentation of physical evidence is an important part of the police investigation and prosecution’s case, should you choose to report the assault.
How Much Will it Cost?
You will not be charged for the sexual assault examination. If you do not have insurance, or you decide not to report the assault to law enforcement, the NH Attorney General’s office will cover the cost of the exam. You will not be billed for anything above the insurance coverage limit.
You will also receive a voucher to cover the costs of a follow-up exam.
What Can I Expect During the Exam?
Crisis Center Advocate
An advocate from the local crisis center will be available to provide you with free, confidential, nonjudgmental, emotional support, information and resources to help you make an informed decision about what type of care you would like to receive.
Evidence Collection Kit
The exam is conducted only with the informed consent of the patient. The exam should not be re-traumatizing for anyone. You may choose not to have any part of the exam that you are not comfortable with.
A medical history will be taken. The sexual assault nurse examiner (SANE)* or doctor will ask you questions about the assault including time and place of the assault, number of assailants, whether a condom was used, if weapons were used, and what type of penetration was performed by the perpetrator. You will also be asked questions about what you have done since the assault, such as whether or not you have showered, douched, changed clothes, defecated, urinated, brushed teeth, etc. The answers to these questions will assist the medical provider in providing you with the most appropriate care.
In some instances of sexual assault, dried deposits of blood, semen or saliva may be found at the crime scene or on the body or clothing of either the patient or suspect. A buccal swab may be taken in order to determine the patient’s DNA profile for comparison with such deposits.
Clothing frequently contains the most important evidence in a case of sexual assault. If you are wearing the clothing you were assaulted in, with your consent, that clothing will be collected as evidence. You will be provided with clothing to wear home from the hospital.
A head-to-toe physical exam will be done to look for bruises, scratches, cuts and other external injuries. With your consent, pictures will be taken of any visible injuries.
If the assault happened within 5 days of the exam, a speculum examination for signs of injury and collection of any physical evidence left by the assailant will be conducted with your consent.
Hospitals may prescribe a prophylaxis to prevent pregnancy. Also known as “Plan B”, these pills are most effective when taken within 72 hours of the assault. The pills may prevent pregnancy, but will not terminate an existing pregnancy. For more information please visit www.go2planb.com.
Sexually Transmitted Infection
You may receive medications or prescriptions for treatable sexually transmitted diseases such as chlamydia, gonorrhea and trichomoniasis. If this is the case, you will receive information for follow-up testing and medications. This is extremely important.
The risk of acquiring HIV infection from a sexual assault are low. The SANE or doctor will discuss the risks factors, and side effects of prophylaxis (medication designed to prevent the spread of disease), with you at the time of the exam. If, based on the assessment, you choose to receive antiretroviral post-exposure prophylaxis, the NH Sexual Assault protocol requires the hospital to provide you with the full 28-day dose pack. You will not be charged for this medication.
* A Sexual Assault Nurse Examiner is a Registered Nurse who has been specially trained to provide comprehensive care to sexual assault survivors, who demonstrates competency in conducting a medical/forensic examination and the ability to be an expert witness if the sexual assault is reported and prosecuted.