Infants exposed to domestic violence have poorer cognitive development

"Something didn't seem right, but I didn't know what to say at the time. I just went on to the next question of the assessment," said Bullock, now a professor emerita at the University of Missouri Sinclair School of Nursing. "We stopped her labor and sent her home, but I will bet my last dollar I sent her back to an abusive relationship, and it sparked my interest in helping other nurses assist battered women. What we didn't know at the time was the impact violence had on the baby."

Bullock helped implement the Domestic Violence Enhanced Perinatal Home Visits (DOVE) program in rural Missouri, which empowered safety planning and reduced domestic violence for hundreds of abused pregnant women. After learning from home health visits that many of the abused women had up to nine different romantic partners during and following pregnancy, Bullock conducted a study to examine the impact of multiple father figures on the cognitive development of the newborn infants.

After administering neurodevelopmental tests during home visits three, six and 12 months after birth, she was surprised to find the infants of women who had only one male partner who abused them had worse cognitive outcomes compared to infants of women with multiple male partners, only some of whom were abusive.

"The findings highlight the variety of ways the multiple father figures may have been helping the mom support her baby, whether it was providing food, housing, childcare or financial benefits," Bullock said. "For the women with only one partner who abused them, the infant's father, the father may not have provided any physical or financial support or played an active role in the child's life. It can be difficult for busy, single moms struggling to make ends meet to provide the toys and stimulation their infants need to reach crucial developmental milestones."

Bullock added that infants coming from homes with domestic violence often go on to have worse academic outcomes in school due to neurodevelopmental lags and a higher risk for a variety of health issues, including gastrointestinal distress, trouble eating and sleeping, as well as stress and illness.

"When nurses are visiting homes to check in on pregnant women and their developing babies, we want them to be trained in recognizing the warning signs of potential intimate partner violence," Bullock said. "I still think back to 1983 when I sent that lady back home into a terrible situation, and I am passionate about making sure I can help nurses today not make the same mistake I made."

"Children exposed to intimate partner violence: Impact of multiple father figures" was recently published in Maternal Child Health Journal. Funding for the study was provided by the National Institutes of Nursing Research. The study involved collaborators from Johns Hopkins University and University of Virginia.