This book brings images of holy motherhood and childbearing into the centre of an art-historical enquiry. By focusing on images of St Anne and the Holy Kinship in Books of Hours made for aristocratic women in relation to the dynastic importance of heirs, it reassesses the role of the female viewer as an active agent in the interpretation of pictures and popular devotional rites. Holy motherhood combines an innovative methodology that draws on art-historical and contemporary gender studies with empirical evidence from fifteenth-century manuscripts, to show how images worked not only to script and maintain gender and social roles within patriarchal society but also to offer viewers ways of managing those roles. Some of the manuscripts discussed are relatively unknown and their images and texts are made available to readers for the first time. The study begins by problematising the notion that intimate, post-partum images of holy childbirth found in Books of Hours provide a window onto the medieval past and women's viewing habits. Through an adaptation of Baxadall's 'period eye', the first part of the book explores how aristocratic lay women - and men - viewed and interpreted images of childbirth by considering their familiarity with prayers for childbirth, the lying-in ceremony and the rite of churching. The second part uses this methodology to interpret the images and prayers in six bespoke manuscripts, including the Fitzwilliam Hours, owned by several Angevin and Breton duchesses, and the Hours of Marguerite of Foix. The book will appeal to advanced students, academics and researchers of Art History, Illuminated Manuscripts, Medieval History and Gender Studies.