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I don't have tons of experience with it, I am interested to see what people say here...
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But I will say it does not always happen b/c of the size of the baby, it is more the size and position of the baby in relationship to the mother's pelvis... for instance, the one true case of dystocia I encountered involved a baby whose head was almost fully out but kept backtracking (the "turtle") as if something inside the mom was keeping the body from emerging (the shoulders being stuck). Mom went on all 4's and the MW reached in to do a sort of corkscrew maneuver. It took time and several pushes, baby born very depressed and the head was dk blue purple but she revived.. she was 7 1/2 lbs. and the mother was not tiny, the baby just got a shoulder wedged behind that pubic bone as she descended and it was tough getting her past it. Conversely, when I was having my son an OB gave me the dystocia speech. He came flying out, very fast birth and he was 10 lbs 2 oz (I am 5'2" about 125 lbs). It saddens me when OB's suggest c sec b/c the baby is getting "big".
 
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