I had it with my first two children because I wasn't educated enough to make a decision other than to say yes. I didn't have it with the twins because they only do it for high risk people or those who are showing symptoms from other tests. In fact my midwife over there was appauled that they would make women go through such an unpleasant test when there is a quick and easy screening available to decide who needs the test. Just my 2c, I would probably still take the test but I wouldn't make a big deal of someone who refused it if they were educated as to why and were eating a healthy diet that would control most GD symptoms anyway.