Ep. 451: Medicaid coverage for doulas - is it really a good thing? with Leslie Moon

In this episode, HeHe sits down with Nebraska doula, childbirth educator, and birth photographer Leslie Moon for a nuanced conversation about Medicaid-covered doulas, birth equity, and the unintended consequences that can happen when community birth work becomes tied to insurance systems and hospital oversight. At first glance, Medicaid coverage for doulas sounds like a massive win—and in many ways, increased access to support absolutely matters. But HeHe and Leslie unpack the deeper concerns many doulas and birth workers are quietly asking behind the scenes: What happens when doulas become accountable to the system instead of the families they serve? Could regulation, certification, and insurance reimbursement slowly reshape doula work the same way it transformed midwifery care over time? Together, they dive into the realities of low reimbursement rates, hospital-employed doulas, licensure fears, and how profit-driven maternity care can directly conflict with relationship-based, autonomy-centered support. Leslie also shares what birth access looks like in Nebraska, where legal out-of-hospital birth options are extremely limited, and why protecting true community-based support matters now more than ever. This episode is thoughtful, spicy in the best way, and packed with bigger-picture conversations about autonomy, advocacy, informed consent, and the future of birth work. Whether you’re a doula, birth worker, or parent who cares about protecting individualized support in maternity care, this conversation will absolutely give you a lot to think about. Chapters:  00:00 Medicaid Doula Hype 01:37 Host Story and Credibility 07:00 Birth Lounge App Pitch 09:50 Medicaid Coverage Concerns 50:17 Regulation Risks and Community Fixes 55:02 Doula Stipend Proposal 01:00:58 Board Certification Debate 01:11:14 Flexner Report Origins 01:14:08 Insurance Strings Attached 01:29:53 Protecting Doulas Call Guest Bio: Leslie Moon is a single mom of 2, a birth doula, birth photographer, and childbirth educator based in Lincoln, Nebraska. She supports families locally with in-person birth support and documentation, and works with families nationwide to prepare for navigating hospital birth in a system that wasn’t designed for birth. She is the co-founder of The Birth Alchemy Course, where she teaches parents how to understand their options, advocate for themselves, and trust themselves throughout pregnancy and birth. Leslie is passionate about protecting relationship-based, community-centered care and helping families feel confident making decisions that align with their values Connect with Leslie:  Novitabirthstories.com birthalchemycourse.com/birth-alchemy-course Listeners can get $100 off our childbirth prep series, the Birth Alchemy Course using code HEHE SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/  Connect with Leslie on IG: https://www.instagram.com/novitabirthstories Find Birth Alchemy on IG: https://www.instagram.com/birthalchemy_official/ BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what’s really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven’t grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/join Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app   LINKS MENTIONED: Here’s a link to the full Flexner Report:  http://archive.carnegiefoundation.org/publications/pdfs/elibrary/Carnegie_Flexner_Report.pdf