I had a pt recently, 19 years old, difficult social situation, in labor, pit aug, but just couldn't progress. I felt at the time that it was fear holding her back, but now I'm thinking it was disgust and being grossed out also. I spent a lot of time working with her, getting her to describe her fears, talking to her about her emotional state, reassurance about the birthing process, etc. I endured her screams, "I don't care about this f-ing baby, just get it out of me!" After birth, when we went to put the little guy on her tummy, she pushed it away. It was difficult, I was pretty disgusted with her inside myself, but never let it show. She was verbally abusive even after the birth. People say, Oh, it's so wonderful to work in labor and delivery. Not always!