The main scene shows the birth of the Virgin Mary. On the left is Noah with the dove in the ark (Old Testament, Genesis 8: 7-8) and on the right: the vision of Balaam (Old Testament, Numbers 24: 17). Inscriptions give the precise Biblical references. The star seen in the vision of Balaam was interpreted as a symbol of the birth of the Virgin. The story of the ark was seen as symbolic of the redemption that the Virgin would provide through her son Jesus Christ.
There are similarities with the 'Birth of the Baptist' in Pittsburg, monogrammed by Jan Rombouts, which is probably by assistants, although this work is weaker still. The headdress worn by the midwife is similar to many seen in paintings of the period around 1520 and associated with artists known as the ‘Antwerp Mannerists’.