When I hand quilt, I need to feel the point of the needle with my bottom finger. I try and make sure that the needle is going down straight through the layers, and as soon as I feel the point I rock the needle back and go back up.
This keeps the stitches on the back reasonably small, and makes sure there is a stitch back there - if I can't feel the needle, it means I haven't gone through all 3 layers.