I think it works nicely even on large quilts, just make sure the top and the bottom are precicely the same size. One suggestion: rather than leaving the opening for turning on an edge..Make a seam in your backing. Sew part of the way across, then backstitch. Then, using a basting stitch, sew 12 to 16 inches further. Return to your regular stitch length, backstitch and finish the seam. After sewing completely around the quilt, open only the basted part of the seam on the backing and turn the quilt by the birthing method. It is so much easier to hand stitch this nice flat opening closed, rather than closing on the edge of the quilt and all the edges are nice and even.