Arimeh - I gained 55 lb in my last pregnancy (so hungry!) and my midwife never pushed for the gestational diabetes test. And my last baby was also 7lb 12oz. I had been working hard to lose weight before I became pregnant, and as soon as I stopped "dieting", combined with being exhausted and feeling like crap if I wasn't eating non-stop, I gained weight super fast. If you've had reasonable sized babies, no family history of diabetes, and are otherwise healthy, I think you're pretty low risk. Talk to your midwife about the risk factors, I guess. As far as age goes, anyone over 25 is "higher risk", but that's virtually all the expectant population these days. As with everything, there's a risk with skipping the test, but it's just a matter of determining your risk/benefit ratio, and deciding what you're comfortable with. If it's on your mind and you're worried about it, then take the test and set your mind at ease.

About the birth - if your midwives aren't OK with screaming women in labour, they're lousy midwives. I'm sure you're not going to shock or offend them with whatever ends up happening during delivery, and I don't think that should stress you out in the least. For what it's worth, though, my fifth baby was my easiest labour. (That was my brow presentation baby. Pushing is where it got hard, but the labour was really easy!) I hardly made a sound through contractions right up until the end - just a bit of low moaning around 9-10cm. I couldn't believe it when they told me I was fully dilated and could push! My other deliveries were much louder. So it definitely could happen that you'll have a very calm and peaceful birth this time, but honestly, don't let that worry you at all!