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! 

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:


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.

Photo Gallery

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.

Photo Gallery

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, doula and student midwife

Jess Mallery

Student Midwife, Birth Assistant

Jess brings a steadying and supportive presence to births at home and the birth center. As the student midwife at The Nest, she attends office visits and births as an important part of earning her degree from the Midwives College of Utah. Her contributions to maternity care and delivery reflect her deep honor for the experiences of pregnancy, birth, and womanhood.

Jessica Smith, Doula and Lactation Consultant

Jessica Smith

Lactation Consultant, Nurse

As your lactation specialist 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.

Midwifery care and a home or birth center birth is drastically less costly than care with a physician and a hospital birth.  Many families appreciate the savings.

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!

"ViviAnne is like a warm hug and cup of coffee along the intimate journey of pregnancy and new motherhood. Check-ins with her always allowed me to feel heard, understood, supported, and most of all peaceful."
"The midwives at The Nest were absolutely crucial to my HBAC success! We received the best prenatal care and prep that lead into a beautiful, safe and healing birth at home. The postpartum care was everything it should be and rarely is in the US. Absolutely the best experience."
"ViviAnne is warm and encouraging, as well as being well equipped and knowledgeable in her craft. She is a good listener and eager to help in what ever way she can. Our family loves The Nest and can’t imagine birth without these amazing ladies."
"Tina is caring and knowledgeable. She remembers the little things."
"At The Nest I had the pleasure of receiving the most holistic, gentle and nurturing prenatal care I could have asked for. As a first time mom, I had so many questions and ViviAnne provided me with so much information & comfort as my mind was often racing! I had the absolute pleasure of having Tina and KO at my home birth. I couldn’t have asked for better support during my labor and delivery. Together they fostered a magical birthing environment including massage, encouragement, and even some laughter that kept my spirits soaring. KO delivered my baby and it truly feels like I could never express my gratitude to her or Tina for all they’ve done for my family. I have nothing but love for the ladies at The Nest. They make me want to have so many more babies!!!"
"KO was the balm to ease my breastfeeding struggles in early postpartum. She provided gentle and loving care to my baby with cranial sacral and tongue tie clipping that meant the difference between tears and cracked, bleeding nipples and the truly phenomenal postpartum bonding experience I was able to have. Truly a 'baby whisperer.'"
"With ViviAnne, you leave each midwifery appointment like you just spent an hour with a dear friend. Her passion and love for being with women and families is apparent in everything she does. The Palouse is so lucky to have her."
"I worked with Vivianne to have a home birth after a traumatic first birth. She was present to my needs and the lingering fears I held and supported me through my prenatal care, and also through the decision making process of having another home birth. She's knowledgeable, straight forward and incredibly supportive. My second birth was beautiful and so empowering and I can't imagine having that experience with any other provider."