This ivory plaque was likely inset into the cover of a precious manuscript. Ivory was considered a precious material, it was often combined with jewels and metal to create treasure bindings (precious covers for manuscripts). It is carved with scenes in three sections. The two uppermost scenes depict the scenes from the Christian bible; the Annunciation (Mary and the Angel Gabriel) and the Visitation (Mary and Elizabeth). The central scene shows the Nativity (birth of Jesus) with Mary lying on a bed and the Infant Christ.