I get an idea, sketch it out, often using Photoshop to resize or move things around. Once happy with the design, I trace it, to size, onto clear tracing paper with a fine point artist pen that will not smear. This becomes my pattern and then I trace pattern pieces from it and use them to cut out my fabric shapes.
Above everything else I am a collage artist or in fabric terms, use appliqué. Even something so small as the eyes of the sun are fused down with fabric and stitched around with a needle so tiny, some threads are to big to go through it. Embroidery is always done after several layers of fabric are stitched down.
I did set up my mother in laws old singer sewing machine in the corner of my studio, thinking it would save me a lot of time, I hardly use it, except for trees, freehand machine stitching trees is a lot of fun!
To confess, much stitching is done on the couch, watching old movies under my great grandmother's handmade quilt of blocks from my great grandfathers shirts, circa 1930's. No matter how tired I am, no matter how crazy life gets...ending the day stitching is always good.
I had an "aha" moment in an antique store, looking at wonderful cookie and biscuit cutters, metal lids, coffee cans, wooden processed cheese boxes...why not use them as frames and containers for my collage work, bringing two things I love together.