Statement of Purpose To describe the proportion of intimate partner homicides (IPH) that include pediatric deaths in the same incident, whether that differs by whether or not a firearm was used, and describe use of protection orders (PO) among IPH victims.

Methods Using the National Violent Death Reporting System we identified all IPH in one of the reporting states from 2003–2017 to define our cohort. We used descriptive statistics to describe incident, perpetrator and victim characteristics in IPH cases where a firearm was used versus not, and where children (<18 years) were also killed or not. Finally, we conducted narrative reviews of Coroner/Medical Examiner and Law Enforcement reports to identify instances with a PO and used descriptive statistics to describe PO use.

Results We identified a total of 8,375 incidents, with 9,130 victims, that were IPH-related. Over half of all victims (58.8%) were killed in a firearm-related incident. A greater proportion of children were killed when a firearm was used than not (proportion difference = 1.6%; 95% CI: 0.8–2.4). Based on narrative review, 5.9% of incidents had a PO filed. No PO explicitly mentioned firearm removal. The majority were granted (95% of those filed), and 23% had been granted within 2 weeks of the incident.

Conclusion The presence of firearms increases the risk of death to children in homes with domestic violence. POs were rarely obtained in our sample of IPH-related deaths, but often granted. Prior literature suggests that POs with firearm removal may be effective strategies for reducing risk of IPH, but we found no mention of firearm removal in POs.

Significance Results highlight the additional risk posed to children in homes with firearms and domestic violence. POs were infrequently endorsed in the narratives, highlighting a potential opportunity to promote awareness and support their use, especially with firearm removal.