Tonga’s Minister of Health said she was shocked by a report on adolescent unplanned pregnancy in Tonga, launched today, “because I did not know that young girls can take their own lives because they find out they are pregnant. ...We cannot continue that into the future!”

The report presented recommendations for long-term changes that need to happen. Hon. 'Amelia Afuha'amango Tu'ipulotu said that repeal of the abortion legislation needs to be studied. “And now we have a piece of evidence.”

The country report for Tonga on “Adolescent Unplanned Pregnancy in the Pacific” presented evidence of the shame that pregnant teenage girls feel in the society, along with a lack of sex education and reproductive education, that leads to fear and hesitancy in seeking reproductive health care, and to poorer outcomes for mother and baby.

“To all the 100,000 population of Tonga and the 50,000 women – we need to stop that right now!” said the Minister in officially launching the report.

She urged everyone, including churches and religious leaders, not to shame teenagers. “We need to still go forward with our cultural values and we need them on board so that we can all go together, forward.”

The Minister said she did not prepare for a speech at the event, but made her heart-felt remarks after listening to presentations from the lead researchers.

“I was shocked to read the girls would rather jump from high places, drink blue bleach, take so much doses of pills, all because within the environment we facilitate shamefulness to such situations. Now is the time for us women to pull down the curtain to stop that!”

Maternal deaths

Tonga has the highest maternal mortality rates in the Pacific, after Papua New Guinea, according to the indicators published in the report.

It recommends that more research on abortion in the Pacific context is needed to better understand practices and links to maternal mortality. The report notes that access to information about sexual and reproductive health, as well as contraceptive commodities, is difficult and access to safe abortion “is simply not an option for adolescents in the Pacific.”

In the Tonga study none of the girls had discussed sex or contraception with their parents or older family members.

Vulnerable girls

The research aimed to understand the contemporary context and realities of adolescents in Tonga who face unplanned pregnancy and motherhood.

The Health Minister applauded the good work done by Dr Christine Linhart of the University of New South Wales, Sydney, and the great leadership of Vanessa Heleta, heading the Talitha Project for vulnerable girls in Tonga.

The launch of the report at the Waterfront Restaurant in Nuku'alofa, was joined by overseas participants on Zoom.

Dr Linhart said the report was based on in depth interviews in Tongan and English conducted in July 2019 with 15 girls aged 16-19 in Tongatapu, Vava'u and Ha'apai. She said that while there is much literature in the area of adolescent pregnancies there were new findings in the report, particularly because it also involved interviews with older women to understand how things had changed in Tonga and their knowledge around methods of limiting pregnancy.

“What we found was that knowledge about contraception and reproductive health was quite low among the young women that we interviewed,” said Dr Linhart. “For a lot of the young women the first physical symptoms of their pregnancy came as a surprise. It's not that they did not understand that sexual interactions would lead to pregnancy, it's just that wasn't a result that most of them had considered was going to happen.”

She said that in a lot of cases when questioned by their parents about a possible pregnancy, most of the girls lied and denied the pregnancy, “which demonstrates the hesitation and fear that they had. Most were incredibly frightened when they found they were pregnant they didn't know what to do.

“Access to maternity services was delayed for most of girls we talked with, because the girls were scared.”

Social media relationships

The report also found that the role of social media was quite strong in the context where parents may not be aware of what is happening in the life of their daughter. Half the girls had met the father of their baby via Facebook –in some circumstances received an out of the blue friend request from a male, sometimes older, that they accepted and began an online conversation with a man, which led to a suggestion from him to meet up.

The girls also turned to the internet to find help “and the problem is that much of the information they found on the internet was unreliable or misleading. The women didn't know what the trusted site would be to go to.”

Sex and reproductive health education

Telusa Tu'ionetoa explained the recommendations in the report.

It called for strengthening existing programs to support youth and promote change equality and challenge harmful gender dynamics; as well as strengthening health and reproductive health education in schools through consultation “to see if there is support for appetite and change before the change is made.”

It also recommendes health care training in sex education and reproductive health and to support “a forum for dialogue between mothers and daughters to start discussions on such taboos.”

The long term changes that need to happen, include calling for ratifications and legislations, in this case relating to abortion.

“While we understand this cannot be done overnight, these are very contentious debatable and sensitive issues - but if we are serious about the need to assist this vulnerable section of society, we need to keep them in mind and continue to progress this discussion within ourselves as Tongans and with others.

“Issues that we sometimes choose to ignore do exist,” she said.

Transformative agenda

The project was supported by Australian Aid, the Pacific Women Shaping Pacific Development , and the Talitha Project Tonga.

Nicholas Murphy, the Deputy Australian High Commissioner, said that Pacific Women is one of Australia's most important overseas development projects with 160 partners in 14 Pacific countries.

Australia has put AUD$30 million toward a four-year transformative agenda for women, adolescents, and youth in the Pacific, “which outlines significant investments in improving sexual and reproductive health in six countries, including Tonga.”

“Australia can make a contribution to better the outcome for women and girls to underpin efforts that are Tonga-owned, Tonga-driven and therefore genuinely transformative.

“This report will guide process for achieving priorities. It is also important to educate young men so they can make informed decisions about safe sex, consent and the use of contraceptives in Tonga,” he said.

- Reporting by Mary Lyn Fonua