About Luna Midwifery


Degra Nofsinger

Lead Midwife

Degra is a Certified Professional Midwife. She studied midwifery school at Maternidad La Luz (MLL) in El Paso, Texas. After completing the midwifery programm at MLL, Degra returned to her native Roanoke, Virginia. She has been attending home births and giving midwifery care since 2007.

Degra participates in a quarterly peer review, continuing education and retain credentialing in CPR and NNR (Neonatal Resuscitation). Degra is an active member of local, state, and national midwifery organizations: VMA (Virginia Midwives Alliance), MANA (Midwives Alliance of North America), NACPM (National Association of Certified Professional Midwives) and ACNM (American College of Nurse Midwives). Degra has served the Virginia Midwives Alliance in several capacities, secretary, president and currently the Regional Representative for the Mountain Southwest Region and the Medicaid Liaison. Degra is involved in volunteer midwifery work in Virginia, and focus on establishing and improving relationships between midwives and various other practitioners and organizations.

When not working Degra loves to spend time with family, hiking, reading and eating really good food! Degra has volunteered on medical trips to Haiti and the Dominican Republic.

Hablo español.

Tiffany Slade - student midwife

Elissa Orr


Elissa is a certified and licensed midwife. She lives in Callands, VA and serves Pittsylvania County, Franklin County, Floyd, Halifax, Roanoke, Bedford, Lynchburg, and Carroll county.

She became a certified and licensed midwife in May 2023. She has attended over 100 births during her midwifery training. She has been a certified birth and bereavement doula since February 2018 and became a student midwife with Breath of Life in March 2019 and graduated in February 2023. She received her birth and bereavement doula training through Stillbirthday University. She is certified in CPR and NRP. Her desire is to help her clients have the best mom-centered birth that they desire.

Danielle Raykes (she/her/hers)

Student Midwife


Danielle was born and raised in the Blue Ridge Mountains of SWVA. Her love of birth work began when she was about 20 years old and started working with a lay midwife. After assisting that midwife for just over a year she stepped away from assisting for a while but continued reading and studying about birth on her own and served as a doula for friends. In 2014 she began her own motherhood journey and welcomed her daughter earthside through a water birth at home. Being pregnant and experiencing birth for herself really relit the fire inside for birth work, particularly home birth. In January 2019 Danielle began assisting Degra at births and in the fall of 2020 she committed to the role of student midwife. She holds current certification in NNR (Neonatal Resuscitation), child and adult CPR, has attended a Breech Without Borders Training and is in phase 3 of the PEP process to become a Certified Professional Midwife (CPM). As a phase 3 student Danielle has the skills to serve as primary midwife under the supervision of Degra. Talk with them today about how you can help further her training by allowing her to be your primary midwife under supervision!

Danielle strives to provide affirming, evidence-based care for all birthing people. She is passionate about birth justice in the BIPOC and queer communities. She sees pregnancy, labor and birth as a sacred, spiritual journey that deserves to be
supported and protected. Traditional midwifery practices have had her heart since day one.

She currently lives in Floyd, VA with her wife, two daughters, and two crazy dogs. In her rare moments of free time she loves to swim, hike, garden, eat good food and spend time with her family and friends.


Tiffany Slade - student midwife

Hannah Milam (she/her/hers)

Administrative Assistant

Hannah is there for all your communication needs, ultrasound scheduling, billing, help with mobile midwife and more. After using midwifery care for her pregnancy in 2022, she was inspired to support the home birthing community and has offered her skills in this current position.

Hannah is an artist, avid baker, and loves to spend time in nature with her family.



Tiffany Slade - student midwife

Rachel Troyer

Birth Assistant

Rachel has been attending births as a Midwife Assistant since 2017. She participates in quarterly peer review, monthly skills practice and retains credentials in NNR (Neonatal Resuscitation) and CPR. Rachel is honored to tend to her client’s safety and empowerment as they give birth at home. She believes that healing transformation is possible when one is held in loving and capable hands, with trust in the inherent wisdom of the body. Rachel holds a B.S. in Environmental Science, and practices Reiki and Biodynamic Craniosacral Therapy.

Rachel lives in Floyd, Virginia with her sweet husband, 2 rambunctious kids, a wild and wonderful garden and too many houseplants. She has helped to guide and create sacred space for women’s circles in Floyd for over a decade. She loves to be in wild places, swimming, hiking and camping.

Hablo español.


What is a midwife?

The Midwives Alliance of North America (MANA) defines a midwife in the following terms:

“Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada.” (source)

The largest ever examination of planned home births in the United States found that among low-risk women, planned home births result in low rates of birth interventions without an increase in adverse outcomes for mothers and newborns, and result in health benefits to mothers and their infants. The study – which looked at nearly 17,000 women and their newborns – found that for planned home births with a midwife in attendance:

  • Over 93% women had a normal physiological birth.
  • A cesarean rate of 5%
  • Only 2.5% of babies admitted to the NICU in the first six weeks of life.
  • 87% of women with previous cesareans had their babies vaginally.
  • Of the 10.9% of women who transferred from home to hospital during labor, the majority moved for non-emergent reasons, like a slow, non-progressing labor, or maternal exhaustion.
  • At six weeks postpartum, nearly all babies were breastfed.

(Sources: 1. Outcomes of care for 16,984 planned home births in the United States: The Midwives Alliance of North America Statistics Project, 2004-2009 – 2. Development and validation of a national data registry for midwife-led births: The Midwives Alliance of North America Statistics Project 2.0 dataset)