If it is your first quilt, please do not think that you will have even stitches, same sized stitches front and back, or perfect stitches. The more you handquilt the better you will become and you will find a method and rhythm that works best for you. All of us can say what works best for us, but it might not work for you. When I have a quilt that has blocks, I use a pvc lap frame and I do not ever have it tight in the frame. But when it comes to sashings or quilts where there is mainly just straight line stitching, then I have become comfortable enough that, as long as I have basted it well, I do not use a frame, will hold in left hand and stitch with right hand. I have handquilted about 8 quilts and without a doubt can tell what quilt was my first one. But I knew not to expect perfection on my first one. Like borntohandquilt said, please do not give up on it. It's a learning process. If after this quilt you feel that handquilting is not for you, the so be it. I'm sure handquilting is not for everyone, but I love to do it, it is a relaxing task for me. Albeit, not a fast task, it is very relaxing for me personally.
Also, I have never handquilted in the ditch, my stitching has always been I think it's called echo or with stencils.