See, I think of the UV map as the pattern, and the texture as the fabric I'm trying to cut to make that pattern look the way I want it. It works fairly well for most things (and my shiny new version of Photoshop lets you preview your textures on the mesh which is great because otherwise I would NOT be making as many baby clothes, let me tell you internets). Since I usually work in small scale-- dollhouse dolls, two to six inches tall, with occasional forays into sixteen-inch fashion dolls-- I am SO USED to having to futz with historical or even 'proper' sewing techniques in order to make things fit, drape, or keep in scale. Sims stuff is REALLY similar, even if it is frustrating taking ages to do things that would take me a couple hours in reality.

I've drawn, and I can usually make sketches to help me draft patterns, but I have ALWAYS had more luck with 3D than 2D.