I did the first 7 times, a mix of land and water births. I would usually yell "GET IT OUT!!!" right at that time. I had 3 episiotomies, one of which ended up being a nasty tear, and one other bad tear for a shoulder dystocia. The interesting thing is, the first 7 times I was afraid to put my hand on my perineum and try to support myself. At my last birth, we had my midwife who sat in the other room. When I got close to crowning, I started to freak out, worried I would tear. All she did was crawl over to the tub and say "Put your hand down there. Feel what is happening. You can do it." I put my hand on my perineum and my baby's head literally just slipped out, no burning at all.
I didn't tear at all with my last 4 births, and I think avoiding the burning had a lot to do with me supporting my body and tissue myself.