The winter conference took place in Deadwood, South Dakota, where Hofer presented her project, “Listening to Loss: A Rural Approach to Community and Clinical Care for Pregnancy Loss.”

Rebecca Hofer stands on a stage, in front of a podium, giving a presentation. Behind her is a screen that reads "Listening to Loss."

Hofer’s project grew out of her passion for rural medicine and interest in expanding access to obstetric care within the Mobridge community, where she was placed for clinical training through the FARM program.

“When I moved to Mobridge, I knew I wanted to work with rural and Indigenous pregnant women,” said Hofer. “The town’s proximity to the Standing Rock and Cheyenne River Reservations, combined with its remote location, over 100 miles away from a tertiary care center, highlights significant disparities in access to obstetric care.”

The project began when Hofer’s attending, Emily Boden, ’15 M.D., clinical assistant professor of family medicine in the USD Sanford School of Medicine, shared her goal of creating a local “Walk to Remember” event for families experiencing pregnancy loss.

“What started as event planning grew into a broader, three-part initiative focused on education, patient-centered care and community engagement,” said Hofer.

First, Hofer conducted a chart review of pregnancy loss cases from 2021 to 2025 to better understand patient demographics and identify opportunities for improvement. Her findings, along with updated clinical guidelines and local mental health resources, were presented to hospital staff.

She also worked with mothers in the community to develop pregnancy loss care kits, which are now stocked in the emergency room, clinic and outreach sites. These kits included educational materials on mental health resources and physical symptoms, as well as memorial items, including a custom engraved keychain, a candle, a journal, a bracelet and a handwritten card.

The hospital's auxiliary committee voted to provide ongoing funding to sustain this effort, allowing the kits to continue after Hofer finished her FARM rotation.

Finally, Hofer and her team launched the “Walk to Remember,” which featured personalized luminary lanterns to honor lost pregnancies. The event resulted in over 140 attendees and a large interest, especially from local leadership, to continue the event as an annual occurrence. 

Rebecca Hofer, middle, stands with friends in front of an aluminum building during the "Walk to Remember" event for families experiencing pregnancy loss.

“This experience reinforced the importance of listening, community partnership and creative problem-solving in rural medicine,” said Hofer. “It continues to shape my commitment to ensuring no patient navigates loss alone. I am especially grateful to Dr. Boden, Anna Douglas and the community leaders who made this work possible and who will continue to support women in Mobridge.”

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