What Patient Choice Really Looks Like in Gestational Diabetes Testing

For decades, gestational diabetes testing has followed a rigid pattern. In most hospitals, the oral glucose tolerance test (OGTT) is offered after 8am, Monday to Friday, in a clinical setting. Appointments are limited, early-morning slots are competitive, and the structure of the test is largely dictated by hospital workflows, staff and space constraints rather than women’s lives.

Until recently, there has been little opportunity to understand what women would choose if given genuine flexibility. With home-based testing through GTT@home, women can choose when to take their test. And the patterns that emerge from the 6500 women tested tell a powerful story about patient preference, daily life, and the hidden costs of rigid healthcare pathways.

Time of Day

When given full flexibility with GTT@home, 62% of women chose to start their test before 8am. A further 33% began between 8am and 10am, and just 5% opted to start after 10am. Why? For many, it is about fitting testing around real life rather than rearranging life around testing.

One common scenario is using the early morning hours efficiently. Women can wake at 6am, take the first blood sample, and then go back to bed. The onboard timer in the testing device alerts them when the next sample is due, allowing them to rest rather than sit in a clinic waiting room for two hours.

For others, the motivation is work. Testing before the working day means not having to book annual leave, negotiate time off, or explain yet another appointment. It allows women to protect income, preserve flexibility, and avoid the stress of juggling employer expectations with healthcare needs.

Pregnant women with children face another layer of complexity. Starting early means testing can be completed before a partner leaves for work, allowing childcare to be shared rather than requiring additional arrangements. What looks like a small scheduling decision is, in reality, a careful coordination of family logistics.

The Day of the Week

Choice matters not just in time of day, but also in day of the week. When given the option, expectant mothers often choose to test on a Saturday or Sunday rather than during the working week. This preference is rarely accommodated in hospital-based testing, yet it reflects how people would naturally choose to manage health around work, school, and family responsibilities.

Weekends offer fewer competing demands, less time pressure, and more control. For patients, this can mean a calmer testing experience, which matters in a diagnostic pathway that already carries anxiety.

What This Tells Us

These choices are not random. They reveal something important: women are not trying to avoid testing. They are trying to integrate it into their lives with minimal disruption.

When healthcare pathways are rigid, we often interpret non-attendance or delayed testing as disengagement. But in some Trusts, women are given a single appointment for their OGTT, with no opportunity to reschedule if life gets in the way. Miss that slot, and the test may not happen at all. Patient preference data suggests the issue is not motivation, but inflexibility. When systems are designed around trust and choice, women engage readily.

Choice is not a luxury in maternity care. It is a tool for equity, adherence, and better experience. By allowing women to decide when testing happens, we gain insight into how healthcare can work with patients’ lives rather than against them. And when we listen to those choices, the message is clear.