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Indian Journal of Community Medicine

Domestic Violence along with its Sociocultural Determinants Among Pregnant Women Attending MCH Clinic of a Subdivisional Hospital in West Bengal

Author(s): S. Mitra

Vol. 31, No. 4 (2006-10 - 2006-12)

S. Mitra

Abstract

Objective: a) To study the occurrence of domestic violence among the pregnant women attending the MCH Clinic of Baruipur Subdivisional Hospital, West Bengal. b) To study the role of different socioeconomic factors behind the occurrence of domestic violence among the women. Study design: Clinic-based, cross-sectional study. Setting: MCH Clinic of Baruipur Subdivisional Hospital, in the District South 24-Parganas of West Bengal, India. Participants: Pregnant women, attending the MCH Clinic of Baruipur Subdivisional Hospital for antenatal care. Statistical analysis: Chi-square test. Results: The study group women were comparatively older than their control group counterparts and consisted mostly of rural Muslim women whereas the majority of the control group women were Hindu and urban. The level of education was higher among the control group than among the study group. Proportion of women engaged in a paying occupation was significantly lesser in the study group than in the control group. The educational level and engagement in a skilled occupation of the husbands of the two groups also showed similar negative associations. The event of giving birth to a male child by the woman was found to have some protective influence against domestic violence. The commonest form of assault was slapping. The main emotional reaction of the victims was anger, the others being fear, guilt and grief.

Key words: Domestic violence, Antenatal women, Nature of attacks, Socioeconomic determinants.

Introduction

Violence affects the lives of millions of women worldwide, in all societies. It hinders the basic rights of women as a human being. The declaration on the elimination of violence against women, adopted by the UN General Assembly in 1993(1), defi nes violence against women as “any act of gender – based violence that results in, or is likely to result in physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life.” Domestic violence encompasses violence against women within the family, i.e., physical and mental assault of women, usually by their husbands, male partners or relatives. (2.3). It has been observed that in many situations, pregnant women become particularly vulnerable to oppression by their male partners (4,5,6).

In India, domestic violence is increasingly being recognized as a health and social problem, which is silently borne by the victims.

There is a dearth of information on domestic violence in India. In the present study, it is intended to fi nd the exact nature of the problem affecting pregnant women and the factors related to it.

Material and Methods

The study was conducted at the Baruipur Subdivisional Hospital in the district of South 24-Parganas in West Bengal, during 2001-2002. It was a clinic-based, cross sectional study. Information about domestic violence was gathered by personal interview, from the women attending the MCH Clinic of the hospital. Importance was given to physical violence in this study, mental violence being difficult to quantify. Role of different socioeconomic and cultural factors were also studied.

Pregnant women attending the clinic were the reference population. At fi rst, rapport was established with the subjects to gain their trust. They were assured on the confi dentiality and anonymity of the study. The women were identifi ed serially from the clinic register and interviewed to detect the cases of domestic violence.

The sample size was calculated considering the prevalence rate of domestic violence as 45%(7) and using the formula 4PQ/L2 at 95% confi dence level and 10% possible dropout rate. The desired sample size came out to be 110. So, 110 pregnant women, affected by domestic violence, identifi ed serially from the clinic register, were taken up for the study. Another 130 women attending the same clinic, without the history of domestic violence, were taken as controls. Personal interview of each participant, maintaining confi dentiality, was taken, using a pretested, semistructured questionnaire. Chi-square test was applied to test the statistical significance of the findings.

Results

In general, the affected women (study group) were older than the non-affected women (control group). In the study group, the largest age-group was 26-30 years (32.72%). In the control group, the largest age-group was 21-25 years (33.84%).

The affected group comprised mostly of rural women (61.80%) and in the control group, the urban women were the majority (53.07%).

As to religion, the percentage of Muslim women was higher in the study group (47.27%) and the percentage of Hindus was higher in the control group (60.00%), the difference being statistically significant. Percentage of Christian women was much smaller in both the groups.

Regarding educational status of the participants, Table- I shows that there were significant differences in the percentage of illiterate women and that of women read up to middle school level, among the two groups, the former being higher in the study group and the latter in the control group.

Table I: Distribution of women according to their education

S. No. Level of education Women affected by
domestic violence
Women not affected by
domestic violence
No. Percentage No. Percentage
1. Illiterate 45 40.90% 34 26.15%
2. * Just literate 18 16.36% 21 16.15%
3. Primary level 25 22.72% 29 22.30%
4. Middle school level 17 15.45% 36 27.69%
5. High school level 5 4.54% 10 7.67%
Total   110   130  

d.f. = 1 χ2 = 10.83 p < 0.001

* [Just literate = Can only sign her name]

Table-II shows that the population of women engaged in a paying occupation was significantly lower among the study group (34.54%), than among the control group (51.53%). This indicates that economically productive role of women among the lower socioeconomic strata may confer some protection to them against domestic violence.

Table II: Relationship between paying occupation of women and domestic violence

S. No. Level of education Women affected by
domestic violence
Women not affected by
domestic violence
No. Percentage No. Percentage
1. Engaged in paying work 38 34.54% 67 51.53%
2. House wife 72 65.45% 63 48.46%
Total     110 130  

d.f. = 1 χ2 = 10.83 p < 0.001

Significant relationship of domestic violence with educational level of their husbands has been found. The group consisting of illiterate and lesser educated persons comprised 70.00% among the husbands of the study group and 49.23% among those of the control group. Conversely, proportion of comparatively better educated husbands comprised 30.00% of the study group husbands and 50.77% of the control group husbands. This indicates that education of the husband may impart some protective infl uence against domestic violence.

Regarding husband’s occupation, only 6.36% of the husbands were skilled workers in the case of affected women. As to the control group women, 37.69% of the husbands were skilled workers. The difference is statistically significant, meaning that engagement of the husband in a (better paying) skilled job has an inverse relationship with the occurrence of domestic violence.

Similarly, significant relationship of domestic violence with deviant behaviour of the husband has been observed. In the case of the affected women, 50.90% of the husbands were reported to behave in a deviant way, whereas in the case of the non-affected women, this proportion was 37.69%, the difference being statistically significant. Here, the category of “behaving in a deviant way” included drug addiction, habitual gambling and practice of visiting CSWs, besides addiction to alcohol.

The social risk factors for violence, as perceived by the affected women, are present in Table-III.

Table III: Social risk factors for violence, as perceived by the affected women

S. No. Perceived risk factor Affected women
No. Percentage
1. Addiction 32 29.09%
2. Poverty 25 22.70%
3. Son preference by husband 22 20.00%
4. Dowry related conflict 19 17.28%
5. Husband’s illicit relationship with other woman 12 10.97%
Total   110  

It is evident from Table-III that the husband’s addiction to alcohol or any other psychotropic substance or drug was maximally perceived as the risk factor for domestic violence by the affected women (29.09%). The other risk factors perceived were poverty (22.70%), husband’s son preference (20.00%), dowry-conflict (17.28%) and the husband’s illicit relationship with other woman (10.97%).

A significant relationship of domestic violence with the gender of the offspring has been revealed (Table-IV), indicating that the event of being the mother of a male child has rendered some protection against domestic violence.

Table IV: Distribution of the women according to their having at least one male child

S. No. Event of having at
Least one male child
Women affected by
domestic violence
Women not affected by
domestic violence
No. Percentage No. Percentage
1. Yes 47 42.72% 73 56.15%
2. No 63 57.29% 57 43.84%
Total   110   130  

p < 0.05

Regarding the nature of assault on the affected women, the commonest were slaps (35.45%). Besides slapping, the various other ways of assaulting included kicks (20.90%), beating with a stick or rod (16.36%), first blow (20.00%), striking with a sharp weapon (5.45%) and others (1.81%). Considering that the assaulted women were pregnant at

that time, the assaults were serious, with hazardous and potentially life threatening implications both for the mother and the growing foetus, besides the emotional injury caused to the pregnant lady.

Regarding the emotional reactions of the victims, four types of reactions were observed. The commonest was anger, shown by 30.91% of the affected women. The other reactions recorded were fear (20.09%), guilt feeling on self (21.82%) and grief (18.18%).

Discussion

In the present study, the affected women were found to be comparatively older than the non-affected women. It was found that the percentage of Muslim women was more in the study group (47.27%) than in the control group (40.00%). Conversely, the percentage of Hindu women was more in the control group (60.00%) than in the study group (52.73%) and the differences were significant. This corroborates the previous finding of Daga et al(8) that domestic violence was prevalent more among the Muslims than the Hindus.

Regarding educational status of the participants, it has been observed that education has a significantly negative relationship with domestic violence. Probably, difference in the level of education among the two groups of women points to a covert cultural difference between the two groups they belong to, which may have associations with the occurrence of domestic violence.

Similarly, an economically productive role of the women has been observed to confer some protection against domestic violence (vide table-II). The earning capability of the women here perhaps, has also earned some autonomy for them, safeguarding against domestic violence.

A significant relationship of domestic violence with education of the husbands has been observed. There is a greater accumulation of comparatively higher educated husbands in reference to the control group (50.76%) than to the study group (30.00%). This observation arouses hope that education may have a distinct role in the prevention of domestic violence. Similarly, the nature of husband’s occupation (i.e. whether skilled or unskilled) shows a significant distribution between the two groups. Skilled workers are in a significantly higher proportion (37.69%) among the husbands of the control women than of the study women (6.36%). This factor perhaps indicates to some economic and cultural difference between the husbands of the two groups, which may have some bearing on domestic violence.

The proportion of husbands possessing a deviant behaviour pattern was found to be significantly higher in respect to the study group (50.90%) than that to the control group (37.69%). This is quite explainable, because the act of wife beating may be considered as another manifestation of this deviant behaviour pattern.

Table-III reveals the social risk factors of domestic violence, as perceived by the affected women. Husband’s addiction to alcohol or other psychoactive substances is observed to be the leading risk factor, stated by 30.00% of the affected women. Other factors mentioned were poverty (22.70%), son preference of the husband (20.00%), dowry confl ict (17.30%) and husband’s illicit relationship with other woman (11.00%).

It is to be noted that all these risk factors are interrelated and interdependent and can be combated by comprehensive socioeconomic interventions, leading to elimination of gender bias, women empowerment and alleviation of poverty.

It has been observed from Table-IV that a significantly higher proportion of the affected women did not have any male child (57.29%) in comparison to the control group (43.84%). This reveals the fact that giving birth to a male child has probably increased the worth of the woman to the husband and has conferred some protection against domestic violence, pointing towards son preference of the husband. However, this attitude of the husbands, as it is deeply entrenched in the psyche of the society from time immemorial, is hard to remove, but can be modifi ed by proper counseling of the husbands and other family members and improving the status of women as a whole.

Acknowledgements

I acknowledge the contribution of Dr. Susmita Roy, Ex-DPH student of All India Institute of Hygiene and Public Health, Kolkata for her painstaking collection of data for this work, under my guidance.

Thanks are due to Dr. P Chatterjee, Ex-Director-Professor and Head of the Deptt. of Public Health Administration, All India Institute of Hygiene and Public Health, Kolkata, for his interest and cooperation in this work.

References

  1. United Nations, Declaration on the elimination of violence against women. Resolution A/RES/48/140 dated 23 February 1994.
  2. World Health Organization, Definition and scope of the problem of violence against women in: Violence against women. Geneva. WHO Women’s Health and Development Programme. 1997.
  3. United Nations. Strategies for confronting domestic violence: a resource manual. Vienna Centre for Social Development and Humanitarian Affairs. 1993.
  4. Martin SL, Mackie L, Kupper LL, Buescher PA, Moracco KE. Physical abuse of women before, during and after pregnancy. JAMA 2001; 285: 1581 – 1584.
  5. Helton AS, McFarlane J, Anderson ET. Battered and pregnant: a prevalence study. Am J Public Health 1987; 77: 1337 – 1339.
  6. Gazmararian JA. Prevalence of violence against pregnant women. JAMA 1996; 275: 1915 – 1920.
  7. Tjaden P, Thoennes N. Prevalence, incidence and consequences of violence against women. Washington DC. National Institute of justice. 1998. Publication NCJ.
  8. Daga AS, Jejeebhoy SJ, Rajgopal S. Domestic violence against women: An investigation of Hospital Casually Records, Mumbai. The J of Family Welfare 1999; Vol. 45; April.

Deptt. of Epidemiology, All India Institute of Hygiene and Public Health, West Bengal, India.
E-mail: [email protected]
Received: 1.2.05

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