What to Expect at the Hospital
Why Should I Go to the Hospital Following a Sexual Assault?
- 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.
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 (see below) during which forensic evidence may be collected. This can only be completed within 5 days of the assault. You have the right to refuse the entire exam or any part of it at any time. You may also decide to complete a forensic exam anonymously.
If you are over the age of 18, and are not suffering potential fatal injuries (gunshot, stabbing) the hospital is NOT to contact the police about your assault, without your consent. For your health and safety, medical personnel are required to notify police of sexual assault victims under age 18.
New Beginnings advocates are available to help you talk through your options at the hospital. If you don’t receive an advocate, please request one, and don’t hesitate to call our Sexual Assault Hotline at 1.800.277.5570.
The Sexual Assault Medical/Forensic Exam
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.)
What is a Sexual Assault Nurse Examiner (SANE)?
A Sexual Assault Nurse Examiner (SANE) is a Registered Nurse who has been specially trained to provide comprehensive, uninterrupted care to sexual assault survivors, including conducting the forensic collection of evidence. The goal of the SANE Program is to minimize the physical and psychological trauma to the victim and to maximize the probability of collecting and preserving the physical evidence of an assault for potential use in the legal system. Mission of the SANE Program
- To avoid further trauma to all sexual assault survivors in the health care environment.
- To provide a compassionate and sensitive approach to sexual assault victims.
- To provide timely medical/forensic examination with more complete evidence collection.
- To provide referral for follow-up care and counseling.
- To provide testimony as needed
How Much Will It Cost?
The patient should never be billed for the SANE exam. The State of New Hampshire also covers the cost of prophylaxis medications (up to $1800) and necessary follow-up visit (up to $200). You will receive a voucher for follow-up care. The State of New Hampshire may also cover other costs that are the direct result of the sexual assault, such as other medical/dental /mental health treatment costs, loss of wages, etc. through the NH Victim Compensation Program. Crisis center advocates are familiar with and can assist in the application process for victims’ compensation.
What Can I Expect During the Forensic Exam?
New Beginnings Advocate
A crisis center advocate is always called by the hospital to respond when a sexual assault survivor presents; however, it is always the choice to accept or deny our services. Advocates can remain in the room for as little or as much of the forensic exam process as the victim/survivor would like. We want to help survivors make an informed decision about their care and are there to provide free, non-judgmental and confidential support.
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 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 (cotton swab to the inside of the cheek) 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 http://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. Follow-up is extremely important. The risk of acquiring HIV infection from a sexual assault are low. The SANE or doctor will discuss the risk 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.