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After being filled, the quilt is stitched together. Of course, in times gone by, the quilt-makers did all the stitching with a hand-held needle. Modernly, however, quilt-makers use a sewing machine to stitch the sides of the quilt together. The machine-stitched sides increase the durability of the quilt. Quilters then use a running stitch on the interior of the quilt panels to hold the fill in place and add to the beauty of the quilt. All this work, from the carding to the filling to the quilting, is typically done by artisans whose families have been practicing these skills for generations.