Midwifery Care with The Nest







We believe that each birth is sacred.
Your birthing experience is an event that imprints on you forever. We recognize this space must be filled with gentleness, honor, love and respect. The process of growing and birthing a baby is challenging work, but it is work that holds great potential for being the most rewarding and empowering experience in a woman’s life and has a lasting impact on her family.
We are here to guide you and your family throughout the childbearing year – preparing you for this transition and an empowering birth.
We support normal, physiologic birth.
Our care integrates the art of traditional midwifery with evidence-based practices.
Our certified professional midwives and certified nurse midwife bring over 40 years of collective experience and have helped thousands of families safely welcome their babies into the world in a variety of settings.
The midwifery model of care is rooted in the belief that pregnancy and birth are normal life processes – while we monitor closely for variations outside of normal, we trust that the majority of women will grow and birth their babies just fine. Pregnancy is not a medical problem and midwifery care is an excellent choice for women who are healthy and low risk.
Throughout the care of the mother and baby, we offer many of the same labs, tests, screenings, medications, etc. that one might receive if they were under the care of a physician or hospital; in addition, we offer guidance in herbs, homeopathy, essential oils, nutrition, exercise, body work, and emotional health.
We want to get to know you.
Shared decision making and informed consent are an essential part of our care. We will take all the time needed for you to feel fully informed and confident in your choices. After sharing information with families about many of the choices they can make, we trust that families will make the best choices for themselves. Throughout the many weeks, we really get to know your family and build relationships. As midwives we really care about women and their families and pour so much of ourselves into this work!
- We offer a free initial consultation appointment for you to meet one on one with a midwife, ask your big questions, and get information to help you decide if midwifery care is for you.
- Prenatal appointments last 30-60 minutes, allowing time to get to know your midwives, answer all of your questions, learn about pregnancy, and prepare for your birth.
- We welcome children, partners, family members, and anyone else you would like to be a part of your experience and care.
- The first week of postpartum care for the mother and baby happens in the comfort of your own home- we come to you! We are checking in on physical and emotional health, performing the chosen tests and screenings for baby, monitoring and helping with breastfeeding, etc. We offer 6 weeks of comprehensive postpartum care.
Every woman deserves the loving care of a Midwife.
Our certified nurse midwife can provide warm, unrushed care for all girls and women, puberty through menopause.
Lifetime midwifery care can include:
- preconception counseling
- annual well woman care
- gynecologic concerns
- birth control / family planning
- lactation support
- pre/post menopause care
CreATE YOUR BIRTH SANCTUARY.
Midwives monitor the health and well-being of the mother and baby, but it is not as simple as only addressing physical health. Normal physiological birth works best when a woman’s space feels safe and protected. We want to create a haven for your peaceful birth; we know from experience that this results in the best outcomes for mothers and babies. We spend time developing and discussing a birth plan with you during your pregnancy, doing our best to tailor our care to your desires.
You will be in close contact with our midwives as labor begins. When the time comes, two of our midwives will meet and be with you throughout the labor process. Knowing everyone in your birth space really creates a sense of ease and allows the hormonal labor orchestra to flow.

Home Birth
An expecting mother may choose to labor and deliver in the comfort of her own home. Midwives honor your turf and bring all the necessary equipment, medications, herbs and supplies. One of our favorite moments is that time after the birth when we have cleaned everything, finished the newborn/mother exam, reviewed postpartum instructions, and tucked your family into bed.

Birth Center in Pullman
We have put a lot of intention into creating a comforting space for women to labor and deliver, full of vitality and love. Birth centers offer a great alternative to home birth when families live far away or feel more comfortable away from home to birth.

ViviAnne Fischer
Licensed Midwife
ViviAnne brings the deep wisdom of experience to her care for women through prenatal, labor & delivery, and postpartum care. She integrates the art of traditional midwifery and current knowledge. ViviAnne enjoys the relationships she develops with families and often creates lasting friendships. Women appreciate her compassionate, calm and patient nature.

Tina Gearhart
Certified Nurse Midwife, Lactation Consultant
As a certified nurse midwife, CNM, Tina is able to provide women’s health midwifery care from adolescence through menopause! She can provide care for well woman exams, labs, family planning, and gynecological concerns. Tina’s straightforward and deeply caring manner really helps women feel informed and empowered in their healthcare. Another lovely benefit of seeing a midwife for care is that it can either be billed through the membership or insurance!

Dr. KO
Naturopathic Doctor, Licensed Midwife, doula
The Medicine Woman of The Nest, Dr. KO guides healing with a sense of patience, ease, and trust. She offers an alternative approach to primary care, acute and chronic maladies, and optimizing wellness. She is particularly gifted with emotionally-focused counseling and bodywork.
As a midwife and doula, Dr. KO brings a tender reverence for the sacred transition of birthing. With a foundation of evidence-based care, she empowers the mother to trust her own body and intuition.
Dr. KO is currently not accepting new naturopathic clients; but you are welcome to call us at 509-330-5539 to discuss options and be added to a wait list.

Jess Mallery
Student Midwife, DONA Birth Doula
Jess provides doula care to families in the hospital, birth center, and home settings. Her goal as a doula is to craft individualized care for her clients and provide a steadying and supportive presence throughout the childbearing experience. Jess is also the student midwife at The Nest, attending office visits and births as an important part of earning her degree from the Midwives College of Utah. Her presence and contributions reflect her deep honor for the experiences of pregnancy, birth, and womanhood.

Jessica Smith
Nurse, Lactation Consultant, Birth and Postpartum Doula
As your doula, lactation specialist and your health advocate, my goal is to compassionately support you through your parenthood experience. I apply a holistic approach to my practice, combining ancient wisdom with evidenced based science to give you a full range of information. My goal is to create a safe space for you to feel connected, honored, and supported in the decisions that give you peace and joy. This is a very challenging, vulnerable, and intimate time in life and having someone to guide you through your journey can be immeasurable. I feel humbled and honored to work beside parents in this transformational time.
- We accept Idaho Medicaid and Washington Apple Health (Molina or Amerigroup) plans. There may be some non-covered services we will discuss with you.
- We accept most insurance plans and are preferred providers with many companies that operate in our area! Even if we aren’t listed as a preferred provider with your plan, check in with our biller because many times we are able to accept it. To learn about your insurance coverage out-of-pocket costs, fill out this link and our biller will do the work for you: https://www.islandbillingseattle.com/estimates
- For families paying out-of-pocket, we offer a cash discount and affordable monthly payment plans.
If you are in need of financial assistance for any of your costs please reach out and ask to fill out our financial assistance form.
At your complimentary consultation, we will give you information about our fees that address your specific financial situation.
Where can I learn more?
Explore the Whole Health Compendium for more pregnancy related resources!