The back of the pillow is actually a sewn piece of fabric. Rows of granny striping adorned with buttons are used to create a strip that runs across the back of the pillow to tie it in with the front design. This pattern comes with excellent information about how to do each step including the sewing. If you aren’t comfortable with sewing, an alternative would be to make two panels of the front design and stitch them together with the pillow in the center.