I have only done one two-sided quilt. It was a baby quilt in flannel. Large squares with applique duckies in the middle of alternating squares (kind of like a checkerboard pattern). I simply matched the squares up from front to back and straight stiched in the ditch along the seams. That way it blended in from front to back. It did turn out to be a little bit heavier than a regular quilt but still very nice :)