Macao’s fertility rate is continuing to decline, with preliminary data from the Health Bureau showing that only 2,871 babies were born in the city in 2025, down 20.38 percent (or 735 births) year-on-year.
According to figures cited by local media, Conde São Januário Hospital accounted for 1,197 births, while Kiang Wu Hospital reported 1,674 births.
When compared to the 1,558 births recorded in 2024, Conde São Januário Hospital’s total fell by 23.17 percent. Meanwhile, Kiang Wu Hospital’s figures dropped by more than 20 percent against 2024’s 2,050 births.
The current decline in the number of babies reflects a steady drop that has persisted in recent years. Between 2020 and 2021, Macao’s live births fell from 5,979 to 5,545, a drop of 7.3 percent.
This negative trend continued into 2021, 2022, 2023 and 2024, which witnessed year-on-year decreases of 9.4 percent (5,026 births), 13.6 percent (4,344 births), 14.5 percent (3,712 births) and 2.8 percent (3,607 births) respectively.
Such figures are a far cry from a decade ago, when the total number of live births reached 7,055.
[See more: Workplace policies could ease Macao’s birth rate woes, experts say]
Macao’s low birthrate has been noted by organisations such as the UN, which reported in its World Population Prospects 2024 that the city had an “ultra-low level” of fertility of just 0.68 births per woman – a figure that is well below the population replacement level of 2.1 births per woman.
The paper noted that the SAR is expected to reach its peak population before 2054, with a zero chance of increasing its replacement rate by that year.
Macao’s shrinking birth rate has led to concerns regarding the city’s ability to sustain a robust work force, declining school enrolments and the allocation of additional resources for elderly services and healthcare.
Chief Executive Sam Hou Fai addressed the issue a number of times last year. In an effort to encourage more births, Macao’s leader introduced several initiatives during his 2025 policy address. They included a new monthly childcare subsidy of 1,500 patacas and a medically assisted reproduction subsidy program.
During the 2026 policy address Q&A session in November, Sam again addressed the topic of the city’s low fertility, while telling legislators that “a declining birth rate is a global trend.” He mentioned that his administration would adopt a three-pronged approach to the issue, tackling it through “support for childbirth, for child-rearing, and for education.”
On the reasons behind Macao’s abysmal birth rates, Yale University sociologist, Emma Zang, told Macao News last year that the reasons for couples not wanting children are usually multidimensional. They include the high cost of rearing a child, the lack of affordable housing and an individualistic culture that makes parenting less appealing.
As for ways to lift birth numbers, Zang said that “there is no very fast, very effective policy,” although offering women more flexibility in their work life could be a vital way to encourage them to pursue motherhood.
