I quilt in whatever direction is comfortable for me and how far I can reach. Usually that's right to left with my right hand. Occasionally it's away from myself with my thimble on my thumb instead. I know if you machine sew or quilt all in one direction you can distort the fabric (Bargello) but I don't think it matters in hand quilting. If you have a round hoop to hand quilt with you can turn it how you want. I like my Q-snap floor frame for hand quilting.