INTRODUCTION

Violence against women, whether pregnant or not is a common occurrence all over the world. It cuts across age, ethnicity, religion and educational barriers. ^{1, 2} The term, ‘violence against women’ refers to any type of harmful behavior directed at women and girls because of their sex. ^{1, 3} It is also known as gender based violence. Violence can take various forms and could be physical, psychological or sexual. It can also be in form of threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life. ^{1, 4} A new dimension has been added to violence in the form of use of acid baths by men to discipline women or girls. ⁵

The prevalence of violence against women ranged between 17-37% with considerable regional variation. ^6-9 Domestic violence is also a form of violence against women and when it involves pregnant women, it calls for a closer attention because of the greater danger it entails. The World Heath Organization (WHO) and International Federation of Obstetricians and Gynaecologist (FIGO) recognize the scourge of violence against women and starting from the nineties has passed various declarations on the elimination of violence against women. ^{1, 10} Factors which lead to domestic violence (DV) are legion and range from no offence, minor to major offences. ^{5, 9}

Most countries and religions frown against domestic violence but because the cultures of the people of these countries do not frown at it, the problem has persisted. ^{1 This} explains the attitude of women to domestic violence, with some even justifying it. ^{1, 5}

The impact of domestic violence on pregnant women is increasingly recognized as an important public health issue that has serious consequences for their physical and mental health. Domestic violence has been associated with psychiatric illnesses like depression, anxiety, posttraumatic stress disorder and suicide. ⁶ It can lead to wide-ranging problems and also has important implications for the fetus. ^{6, 7} This study attempt to document the prevalence, knowledge and perception of domestic violence (DV) among pregnant women in Zaria northwestern Nigeria.

MATERIALS AND METHODS

Two hundred and seventy Consecutive women attending the antenatal clinic of the Ahmadu Bello University Teaching hospital (ABUTH) Zaria, Nigeria, over the period of one week in September 2002 were serve with pretested structured questionnaire, by one of the authors (N. A.). The first five questions centered on biosocial variables including age, parity, educational level and social class. The last seven enquires explore the knowledge and perception about domestic violence among the patients. Experience with domestic violence was also sought. The data was analyzed using Epi- info version 6 statistical software.

RESULTS

One hundred and seventy eight questionnaires were returned duly completed. The mean age of the respondents was 26.7±3.3 years (Range 16-42 years) and most frequent age group was 26-30 years (38%). 93.9% of the women were married. Forty four percent were of Hausa-Fulani extraction while the remaining 46% were other tribes. One Hundred and forty (79%) were educated up to secondary school level. Ninety-nine (55.6%) had knowledge of domestic violence while 79 (44.4%) had no knowledge of it.

On their view about domestic violence (Table 1), 87 (48.9%) felt it was excusable under certain circumstance while 26 (14.6%) felt it is always excusable.  A total of 50 (28%) of the respondents had experienced domestic violence against them in the index pregnancy or in previous pregnancies (Table 2); 18(36%) were beaten up, 11 (22%) were forced to have sex, 10 (20%) had objects thrown at them, 9 (18%) were slapped, and 2 (4%) were flogged.  The culprits in the 50 women who experienced DV are shown in Table 3.  The spouse was the commonest culprit.

On their reaction if they experienced domestic violence against them (Table 4); 64 (35.9%) would keep it secret, 49 (27.5%) would report to their family, 28 (15.7%) would report to the doctor, while others would report to the in-laws, police, clergy or tell a close friend.

Table 1: View about domestic violence amongst the pregnant women

View	No. (%)
No reply	26 (14.6)
Excusable under certain conditions	39 (21.9)
Always excusable	26 (14.6
Not excusable	87 (48.9)
Total	178 (100)

Table 2: Type of domestic violence experienced by 50 pregnant women

Type of domestic violence	No. (%)
Beaten up	18 (36)
Forced to have sex	11 (22)
Objects thrown at her	10 (20)
Slapped	9 (18)
Flogged	2 (4)
Total	50 (100)

Table 3: The culprit responsible for domestic violence among 50 women

Culprit	No. (%)
Spouse	17(34)
In-laws	13(26)
Boy friend/friend	11(22)
Neighbours	7 (14)
No reply	2 (4)
Total	178 (100)

Table 4: Reaction of the pregnant women to domestic violence

Reaction to domestic violence	No. (%)
Keep it secret	64 (35.9)
Report to family	49 (27.5)
Report to doctor	28 (15.7)
Report to in-laws	1 4 (7.9)
Report to police	9 (5.0)
Report to clergy	6 (3.4)
Tell a close friend	5 (2.9)
No reply	3 (1.7)
Total	178 (100)

DISCUSSION

The family is usually seen as the primary unit in the society, the first medium of socialization. Studies have revealed that the family is for many a ‘saddle of violence’, a place where much violence is directed at its female members. ¹¹ From the present study, 28% of pregnant women attending our antenatal clinic had experienced domestic violence, either in the index pregnancy or in previous pregnancies and 56% of the respondents had knowledge of domestic violence This is similar to reports from Enugu (Nigeria) ⁹ and Ghana. ⁷ Most of the pregnant women were aged 26 – 30 years, which is similar to findings from Ghana ⁷ and Enugu. ⁹ This is the most fertile age group for women and so they are more likely to be victims of domestic violence in pregnancy. Most of the respondents where Hausa, which is the predominant tribe in this part of the country.

Most of the victims of domestic violence in this study were beaten up while others were forced to have sex or had objects thrown at them. This is consistent with established data in Africa. ^{3, 4, 7, 9} Though most of the women felt that domestic violence is not excusable; the fact that some felt it can be excused under certain conditions or always is rather disturbing. If pregnant women feel that domestic violence is excusable if carried out against another pregnant woman, then much work needs to be done to correct this perception. This may not be unrelated to the cultural view that domestic violence is a means of correcting an erring wife, just as an erring child is corrected. ^1,12 It’s important to note that the constitution of the federal republic of Nigeriaallows for respect of human rights. ¹¹ However, section 55 of the penal code states that ‘nothing is an offence which does not amount to infliction of grievous hurt upon any person and which is done by a husband for the purpose of correcting his wife, such husband or wife being subject to native law or custom in which such correction is recognized as lawful.’ ¹³ This section is grouped under correction of servant, child, pupil or wife. So where does the pregnant woman stand as far as this penal code is concerned? This may be the reason why most of the pregnant women in this report would want to keep any act of domestic violence against them secret, as in other reports. ^{1, 7, 9}

The attitude by the women of wanting to keep any act of domestic violence against them secret may also not be unrelated to the fact that the spouse is the most likely culprit and the woman may want to protect him because she loves him. She may also be afraid of ridicule from the family and friends. She may not want to report to the police for fear of losing her source of economic subsistence if the spouse is apprehended. They may also fear the worse treatment from the spouse if a report is made to the police. It is possible that the police or judge may advice an out of court settlement to avoid dabbling into family matters. ^{1, 12}  

Suggestion has been made to include screening for domestic violence in routine antenatal clinics, ² but this will involve the allocation of more time for interaction with the patient and training of health personnel in this regard. Involving men in the management of their pregnant wives may assist them to be understanding and be more patient with their pregnant wives. In-laws who carry out acts of domestic violence may be deterred if they are enlightened about the physiology of pregnancy. These in-laws may include other women, mother in-laws and sister in-laws. Women have a significant role to play by bringing up children in love, teaching their male children to grow up with consideration for women and a dislike for domestic violence. Women should not encourage domestic violence as mother or sister in-laws.  The constitution of Nigeria should make domestic violence a punishable offence so as to discourage perpetrators. The formation of support groups may provide comfort for the pregnant woman who is a victim of domestic violence.  

In conclusion, DV is common in Zaria and further studies are needed to determine the pregnancy outcome in patients with DV. Screening for DV should be included into our routine antenatal management protocol.  

REFERENCES

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10. FIGO committee for the study of ethical aspects of human reproduction. Violence against women.  Tropical Journal of Obstetrics and Gynaecology 1996; 1: 72.
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