The thing is, I'm an idiot.
I mean, of course in retrospect, it's easy to see what happened. But how could I have become so willing to believe things were fine when all the evidence was right there? The thyroid specialist said my levels were consistent with post-partum thyroiditis. My iron levels dropped like crazy, really seriously in a short amount of time. And the quad-screen results were too wacky, showing too many different possibilities. Down syndrome shows up as low AFP and uE3 with high hCG. Trisomy 18 shows low levels of all markers. SLOS is indicated by extremely low uE3. Demise shows as high AFP and hCG and low uE3. See? It doesn't make any sense.
And yet my OB looked genuiniely shocked to hear that there was no heartbeat. As shocked as I was, really. I honestly don't think she would have proceeded as confidently as she did if she had thought there was even a chance of this. And, looking back, I guess I wouldn't have, either.
I never really got the hang of the doing my own doppler. I only got it after my last appointment with the OB, when we heard a great fetal heartbeat of 150. I never heard anything over 142, but that's within the normal range of 120 - 175, and actually 140 is dead-on average for a 17 week fetus. It's also pretty average for a nervous woman with no iron in her blood. It was my own heart-rate I was picking up. I had my last appointment with my OB at 14w5d, which is pretty much what the ultrasound measured. So I probably never even had the chance to find the real fetal heartbeat - a few days later it was most likely not even there, but my own blind confidence never ever let me consider that as an option.
I was so attached to the idea of staying calm and not freaking out over everything that I didn't even notice the obvious signs. Like my own post about how much my body didn't want to be pregnent. I just hung onto the fact that second trimester miscarriages are rare. I thought the NT scan results and the good heartbeat were enought to hang my hopes on. NT and first trimester screening tests are much more accurate than the second trimester tests for Down syndrome, and a strong hearbeat and appropriate growth are pretty good indicators of viability. I let myself stop being a nervous wreck. And although I KNOW that being more hypervigilant wouldn't have saved this baby, it might have helped me figure it out sooner, so that at least I might have had a chance to know what really happened.
I don't know much about the d&e. The doctor came to talk to me afterwards and said it would be almost impossible to do genetic testing on the tissues because of the length of time since the demise. They will analyze the placenta, but it had detiorated significantly. I never knew what really made this pregnancy happen in the first place, so I had to accept "luck" as the reason. And now I'll probably never know what happened to end it, so "luck" will have to take the blame, too.