This is a Marian theme, moving away from the traditional image of the Madonna and Child, of a young woman in late stages of pregnancy. She is presented in the chiaroscuro style of the old masters such as Carravagio, Rembrandt, or Honhorst. The painting alludes to a modern day image of teenage pregnancy, an unmarried mother expecting to ‘tie the knot’. To the right of the painting we see a heavy red cord resembling an umbilical cord, with 39 knots tied to it, and Mary is holding the 40th thread. This number is symbolic of the number of weeks in the gestation period before a new life can be born, the 40 days that Christ spent in the wilderness before his ministry, 40 less one lashes he received as part of his suffering, and the 40 years that the Israelites spent wandering in the desert.