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This icon is an unusual rendering of a well-known subject, the birth of the Mother of God. The image has a strong architectural configuration (with a domed roof recalling the structure of a church) that compartmentalises the various scenes. In the top-centre section, St Anna is shown resting on a bed after she has given birth to Mary, with midwives holding gifts of eggs and a cup, symbols of fecundity. Below this scene the midwives are washing Mary. To the right of this we see Anna and Joachim embracing by the Golden Gate - an erotic symbol of the conception of Mary. While on the left Joachim is shown enthroned as he blesses the viewer with his right hand, and holds his attribute of shepherd's staff in his left. The vigorous inner power and self-control that Joachim manifests in this image recalls the description of him by St John of Damascus as an ascetic shepherd who 'kept as strict a watch over his thoughts as a shepherd over his flock, having them entirely under his control.'
Above, at the top of the panel, a half-length depiction of Christ is shown within a golden sphere blessing the scene. Anna and Joachim are also shown standing on the roof of the building and looking up to Christ with hands raised in worship and supplication.
The feast of the Nativity of the Virgin originated in 5th century Jerusalem. The narrative derives from the Protoevangelium of James (an important 2nd century text of the New Testament apocrypha). For example, the scene describing the birth of Mary:
And her months were fulfilled, and in the ninth month Anna brought forth. And she said to the midwife: What have I brought forth? And she said: A girl. And said Anna: My soul has been magnified this day. And she laid her down. And the days having been fulfilled, Anna was purified, and gave the breast to the child, and called her name Mary.
The iconography is usually the first in the 'feast tier' section of an iconostasis, as it can be understood as the origin of all feasts. Vespers for the feast (September 8th) magnify the significance of the event: 'Today Anna the barren gives birth to the Mother of God, foreordained from all generations to be the habitation of the King of all.'