**2. Methods**

This research was a mixed method (quantitative-qualitative) which was conducted from June to August 2015. The samples involved were pregnant women in the third trimester in the Pedungan Traditional Village area in Denpasar City (31 people) and in Nongan Village in Karangasem Regency (33 people). The location selection was based on the consideration that the two areas represented the living conditions of the people in Traditional Villages in urban areas and in rural areas in Bali. Traditional Village is the foundation of community life in Bali. The instruments used were self-reported questionnaires, in-depth interview guides and observation sheets. The data collector recorded the results of the interview using a recorder which was then translated into notes.

Quantitative data analysis used univariate test in the form of proportions, bivariate analysis with Chi-square test. Qualitative analysis with content analysis. Data on the history of violence by husbands were obtained from husbands through in-depth interviews. Due to confidentiality and safety reasons from the respondent, the researchers explored information about the history of DV incidents experienced by women without their husbands. Likewise, when researchers asked for information about acts of violence against women that had been committed by husbands in the last 12 months. Researchers also provided some equipment in the form of tissues and candy when collecting data because the questions were very sensitive and caused respondents to recall painful events they had experienced. The husbands of pregnant women were also included in this study. Questions to husbands were related to their previous experience in the last 12 months, whether or not they had committed acts of violence against their wives and what was the reason.

### **3. Results and discussion**

#### **3.1 Domestic violence form**

There are several forms of violence against women according to the life cycle according to the World Health Organization (WHO), namely: pre-birth, infancy, girlhood, adolescence and adulthood, and elderly. The form of violence in the prebirth phase is in the form of abortion due to gender selection and due to blows and kicks on the mother's stomach. Child marriage, female genital mutilation, physical, sexual and psychological abuse, incest, child prostitution and pornography is a form of violence that most often occurs in girlhood phases. Dating violence and courtship violence (e.g. rape or forced sex with threats), forced sex work due to economic pressure (e.g. marital rape, dowry abuse and murders), partner homicide,

psychological abuse, abuse of women with disabilities, and forced pregnancy is a form of violence that most often occurs in adolescence and adulthood phases [15].

Based on data of National Commission on Violence Against Women of Indonesia (2020), recorded that the most reported area of violence cases is domestic violence (DV) or personal sphere. The percentage reached 69% of the total cases during January–May 2020. This was followed by violence in the community (30%) and state (1%). Women experience higher incidence of violence due to low education, economic dependence, parenting in families that accept violence and give boys special treatment. Studies estimate that, from country to country, between 20 and 50 per cent of women have experienced physical violence at the hands of an intimate partner or family member [16].

Forms or manifestations of violence against women include physical, emotional or psychological abuse, sexual, social and economic abuse [9, 15, 17–19]. According to Digest (2000), found that physical abuse such as slapping, beating, arm twisting, stabbing, strangling, burning, choking, kicking, threats with an object or weapon, and murder. It also includes traditional practices that harm women's reproductive health, such as genital mutilation and sexual abuse. Psychological abuse takes the form of threats that can cause deep trauma to the victim. Economic abuse includes actions such as not providing expenses or income to the wife/partner to pay for household needs, as well as costs for maternity care and access to health care facilities. Social abuse includes the perpetrator prevents the wife/woman from meeting or socializing with friends including relatives and other close family members. This includes blocking the use of means of communication/telephone [5, 8, 9, 15, 16, 18, 20, 21].

In general, the role and function of midwives in the community regarding early detection and management of women victims of DV is still very limited, especially in Indonesia. The results of a study conducted by the National Committee for Women in Indonesia (2019) obtained data from 2008 to 2019 there was an increase in the incidence of violence against women from 54,425 cases to 431,471 cases. The increase in cases is almost tenfold. The most reported form of violence against women was DV, amounting to 71% or as many as 9,637 cases. The highest reported forms of DV were physical violence (3,927 cases/41%), sexual violence (2,988 cases/31%), psychological violence (1,658 cases/17%) and economic violence (1,064 cases/11%). The province known for the highest domestic violence report until 2019 was West Java (2,738 cases), followed by Central Java Province (2,525 cases), Capital city of Jakarta (2,222 cases). Data from the Integrated Service Center for the Empowerment of Women and Children in Denpasar City (2019), it was found that there was an increase in the number of cases of domestic violence from 2014 to 2018 by more than 100%, from 4 cases to 47 cases. The cases of sexuality also reported increase from 4 cases to 16 cases or increased fourfold from 2014 to 2018. Unfortunately, the incidence of violence during pregnancy is not available data in a large scale. The results of a study in Bali (2015), found that as many as 1 in 4 pregnant women have been victims of violence by their husbands or partners in the last 12 months [18].

#### **3.2 Pregnant woman and partner characteristic**

There was a significant difference in the characteristics of the respondents according to the level of education of the mother and the husband's education. Gender inequality [22, 23], culture, norms, values, beliefs [8, 9], lower socioeconomic status [24] as a risk factor for domestic violence among pregnant women. Male partners who abuse alcohol or use drugs, are unemployed or intermittently employed, have less than a high-school education is the cause of the increase in violence against women [23, 25].

*Domestic Violence in Pregnant Women and Their Types. Case Study in Bali, Indonesia DOI: http://dx.doi.org/10.5772/intechopen.98669*

The ecological framework in violence against women includes: individual level have been a victim of violence in the family, for examples: become addicted to alcohol and illegal substances and parenting; relationship level (such as family, friends, intimate partners and peers may influence the risks of becoming a victim or perpetrator of violence); Community level (social relationships occur, such as schools, neighborhoods and workplaces, also influence violence); and societal level (influence whether violence is encouraged or inhibited. There is an understanding that acts of violence are considered as a natural thing for men to do against women to maintain economic stability, avoid social conflicts, and even perpetuate subordination. [3, 9, 19, 21, 23, 26–28] (**Table 1**).

#### **3.3 The experience of domestic violence by partner or husband**

It is known that globally, more than one third of women aged 15 to 64 have been victims of violence by an intimate partner or husband. This number is consistent with global figures on gender-based violence [29]. The condition of women in Bali, who are predominantly Hindu, has a marriage value in the form of "mesatya". "Mesatya" is a value about loyalty to their spouse or husband and the husband family to death. Or the same as the principle of getting married once in a lifetime. No matter how difficult the problems faced when married, it must remain obedient and obedient to her husband and family. One factor that triggers the DV is that the value or belief that women or wives are the property of their husbands, the husband has the right and is accepted if he treats his wife at will [2, 19].

Differences in the incidence or experience of domestic violence for pregnant women in the last 12 months in Pedungan villages and Nongan villages with


#### **Table 1.**

*Results of the characteristics on fertile age couples in Bali, 2015.*

sociodemographic characteristics obtained that there was a significant negative correlation (r = −0.34) and (p < 0.05) between the age of the respondent or pregnant women in the village of Pedungan with a history of domestic violence in the last 12 months. This shows that if the pregnant woman gets older, the incidence of domestic violence is lower. Meanwhile, there was no significant correlation between the age of pregnant women and a history of domestic violence in the last 12 months (p > 0.05). The forms of violence experienced by pregnant women in the last 12 months in Pedungan Village showed that as many as 3 pregnant women admitted to experiencing physical violence in the form of: husbands throwing objects/items that are dangerous to the mother (2 people/6, 45%) and the husband threw things/ objects including the mother's pet (1 person/3.23%).

In this study, the results showed that the number of women who had experienced DV in the last 12 months in Pedungan Village and in Nongan Village was not statistically different (p > 0.05). The number of women who had experienced DV in Nongan Village was higher than in Pedungan Village (15 people out of 33 people/45.45% vs. 10 people out of 31 people/32.26%). One in four pregnant women claimed to have been a victim of domestic violence by her husband in the last 12 months. Some respondents said there was a desire to leave their husband/ partner, but this desire was rejected by parents [19]. The incidence of physical violence and sexual violence was more experienced by women in Nongan Village than in Pedungan Village (6.45% vs. 3.23%). On the other hand, incidents of sexual violence and emotional violence were mostly experienced by women in Pedungan Village [18].

The influence of traditional and religious values is very strong, especially in regions that still carry patriarchy. Women must be obedient and submit to their husbands and families [6, 7]. Almost all women who have been victims of DV in the study said that they never told others about the violence, including their family or parents. Shame, fear, and even being blamed are the main reasons women victims of violence do not share incidents of violence with others. Domestic problems are a big shame to share with others or taboo [5, 9, 10, 15, 21, 30]. This condition can worsen the situation of women. According to Kyriacou et al. (1999) suggest that women as wives are considered as the property of their husbands [25].

There is an assumption among Balinese women, that husbands have rights over women including how a woman is treated. The results obtained through selfreported questioners regarding the knowledge and attitudes of pregnant women about domestic violence, that most wives agree that a wife must always obey and follow the husband's orders. A husband can scold his wife for not obeying her wishes [19]. Women or wives in Bali still adhere to the concept of marriage, which is the embodiment of loyalty until death. The divorce process is also very difficult, because it must involve the role of traditional leaders before the court decision [2, 19, 31].

Balinese women are synonymous with individuals who obey and follow the decisions of men, especially husbands. A married Balinese woman must follow her husband, including living in a male family. In the environment where the husband lives, it is not uncommon for the wife or woman to live in an extended family, namely with the parents of the husband or in-laws, relatives of the husband or in-laws and even other family members. This condition is suspected to have triggered acts of domestic violence against women, especially wives. Balinese society in general adheres to a fatherly system (Vederrechtelijk) or in Balinese terms it is called "Purusa". The main thing that is understood from the fatherly system in Bali is the position of men as "Sentana" from the Purusa family line. The men who is the heir in the family [2, 31].

*Domestic Violence in Pregnant Women and Their Types. Case Study in Bali, Indonesia DOI: http://dx.doi.org/10.5772/intechopen.98669*
