Apse, Basilica of Santa Maria Maggiore, Rome
There are no midwives and the manger scene is in a built structure rather than a cave, but in other respects the composition looks to older and Byzantine models: The Virgin Mary herself is in a sort of cave, compositionally separate from the child; Joseph rests his head on his left hand; and the stable is re-imagined as a classical temple or early church. Behind the structure, an angel announces the birth to two shepherds.
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Photographed at the basilica by Richard Stracke, shared under Attribution-NonCommercial-ShareAlike license.