NORTH PLATTE, Neb. — Faith Cleveland had two normal pregnancies, but this one was different. She seemed to be bleeding constantly, with no explanation. However, her baby appeared healthy and was growing normally. She and her boyfriend, Harley Smith, were looking forward to her March 6 due date.
On Nov. 5, Smith's mom, Tammy Scott, rushed Cleveland to the emergency room at Great Plains Health. "When Dr. (Michael) Bianco got there I was already 7 centimeters dilated," Cleveland said. "I was only 21 weeks and five days." Full term is 40 weeks.
Cleveland felt her heart break as she was told that her baby likely wouldn't survive, but she asked Bianco to do everything he could to save her little boy.
"At 22 weeks there's a very low rate of survival," said Dr. Soogandaren Naidoo, a pediatrician at Great Plains Pediatrics. "I was called in. The delivery was very fast — I think I got there 30 seconds before the baby was born."
Monitors had detected a heart rate before the baby was born, but as Cleveland awaited the cry parents instinctively expect, she heard nothing — not even a beep from the heart monitors.
"He had no heart rate and he was not breathing," Naidoo said. "The baby was thought to be dead. They couldn't pick up anything with the monitors."
Cleveland said she doesn't remember much of what happened next. She caught a brief glimpse of her son — his underdeveloped skin was purple, and he was tiny. She named him Harley Wade Smith, after his dad.
"He could have fit in the palm of my hand," Scott said.
Harley weighed just 1 pound, 9 ounces and was 12 inches long. "I felt a very small heartbeat," Naidoo said. "It was very, very faint."
Naidoo intubated the little boy, which was nearly impossible because he was so tiny, and began performing chest compressions. Harley's oxygen levels slowly began to rise. Doctors stabilized his heart rate until a flight team arrived to transfer him to St. Elizabeth Regional Medical Center in Lincoln. Staff members say he's likely the youngest baby to be stabilized and transferred to St. Elizabeth.
"The doctors in North Platte did an excellent job," said Dr. BJ Wilson, a neonatologist at St. Elizabeth. "That was not a routine day in the office for them."
It wasn't routine for the doctors at St. Elizabeth, either. Wilson said that in the past 10 years the hospital has had only about 30 babies in similar situations.
Wilson said the survival rate for babies around 22 weeks old at St. Elizabeth is approximately 20 percent.
Today, Harley remains in the neonatal intensive care unit at St. Elizabeth. He weighs 7 pounds, 10 ounces.
He was able to switch from IV nutrition to a feeding tube but cannot eat on his own yet. He has a chronic lung infection and may need laser surgery for a vision condition common in premature babies. It's unclear what long-term health problems Harley may have.
Recently Harley fought through a near-deadly bout of pneumonia. He has undergone spinal taps and blood transfusions, stayed under UV lights and been on and off a ventilator — but he's alive, and Cleveland is full of hope for her son's future.
"He's amazing," Cleveland said. "He's been through so much, and he's still fighting."
Naidoo still checks on Harley almost daily and is also impressed by his resilience. The staff at St. Elizabeth has fallen in love with the feisty little boy, which brings Cleveland comfort because she can't always be with him in Lincoln.
"We've taken Harley in as our own," said Missy Wilson, a nurse in the NICU. "We mother him when his parents can't be here. It's probably the best part of our job."
Wilson, the neonatologist, said the staff takes things day by day with babies like Harley.
"He's at risk for having (developmental) problems," the doctor said. "It's hard to predict. We've seen babies this small that we thought weren't going to live and they did."
It's uncertain when Harley will go home. Whatever happens, Harley's family has faith.
"It's in God's hands," Scott said. "He's going to pull through — I know he is."