Ivory was used all over Europe for religious works of art. It was often combined with precious metals and usually took the form of relief panels, for book covers, portable altars and caskets. An almost unbroken tradition of ivory carving extends from the Roman and Byzantine empires until the end of the 14th century. From about 1250, Paris became the centre of production for figures and reliefs intended for private devotion.
Three dimensional images of the Virgin and Child were ubiquitous from the twelfth to the fifteenth centuries, produced in a wide range of materials and sizes and testifying the overwhelming devotion to th Virgin. Together with the Crucifixion, statues and statuettes of the Virgin and Child were the pricipal objects of devotion in the Christian Church, and vast numbers were made for ecclesisastical, monastic and private worship.