OniBarubary
Banned
Iosefka is the alien and the women upstairs is an impostor, I think so at least.
Pretty sure that's confirmed. The woman upstairs is a member of the Choir and basically took over her clinic to continue the experiments into making Celestial Emissaries. That's why you find one in there (Iosefka) and the path out back that leads to the Forbidden Woods is full of them too because they were either cast off failures or they needed to be grown there.
Pretty sure Iosefka is dead/Emissary before the game begins. There's some item thingies as well as what happens to her if you don't fight her until after Rom that make it pretty clear, I think. Also, I'm...not sure why you can get an Umbilical Cord from her other than maybe her experiments actually proved successful though it cost her her sanity.