With my 3rd, who was posterior and big, the doc said "one more push". One push later and not out, so he said to push again. I told him "you promised just one more push" I cried and then said " You broke your promise so you it get out yourself!" Obviously I pushed again! With bub 5 i was bearing down while standing up and told the midwife to catch him. My waters broke all over the poor woman and i burst into fits of laughter while my son did come out.