Analysis of the Relationship of Knowledge and Attitude of Pregnant Mothers with Utilization of MCH Book Gusti Ayu Gita Maharani 1 , Pirlina Umiastuti 1,2* , Euvanggelia Dwilda Ferdinandus 1 1 Department of Midwifery Education, Faculty of Medicine University Airlangga 60132, Surabaya, East Java, Indonesia 2 Department of Public Health Sciences-Preventive Medicine, Faculty of Medicine University Airlangga 60132, Surabaya, East Java, Indonesia Corresponding Author : pirlina-u@fk.unair.ac.id Abstract Background Global maternal mortality data in 2017 was 295,000 maternal deaths. Efforts to minimize maternal mortality can be made by maximizing quality pregnancy care to ensure the condition of the mother and fetus are in good health. MCH handbooks for pregnant women are an essential tool during pregnancy. This study aims to determine the relationship between knowledge and attitudes of pregnant women about MCH books with the use of MCH books for pregnant women. Methods This type of research is an analytic study with a cross- sectional observational research design. The sample of 48 pregnant women respondents and data analysis using Chi-Square test. Results: The results showed that pregnant women who had good knowledge were 21% and 79% sufficient, positive attitudes were 48% and negative attitudes were 52%, and on the use of MCH books, pregnant women who used MCH books were 52% and did not use MCH books. MCH as much as 48%. Results of the Chi-Square test showed that there was a relationship between knowledge and the use of MCH books with p = 0.39 (> 0.05) and the relationship between attitudes and the use of MCH books with p = 0.00 (<0.05). Conclusion The data shows no relationship between knowledge of pregnant women about MCH books and the use of MCH books for pregnant women. There is a relationship between attitudes of pregnant women about MCH books and the use of MCH books for pregnant women. Keywords: Knowledge; Attitude; MCH Handbook; Utilization 1. Introduction Global maternal mortality data in 2017 was around 295,000 maternal deaths, with a maternal mortality rate of 211 per 100,000 live births (World Health Organization, 2019). In Indonesia, the number of maternal deaths in 2019 was 4,221 cases, with a maternal mortality rate of 305 per 100,000 live births. (Kemenkes RI, 2019). Meanwhile, there was an increase in maternal mortality to 110 cases in the Lampung province, with a maternal mortality rate of 75 per 100,000 live births (Dinas Kesehatan Provinsi Lampung, 2019). Efforts to minimize maternal mortality can be made by maximizing quality pregnancy care to detect early abnormalities experienced by pregnant women. (OPD Dinas Kesehatan Provinsi Lampung, 2019) In improving mothers' understanding of pregnancy care, monitoring early detection, and ensuring that the health services they receive are met, the use of MCH handbooks for pregnant women is an essential tool during pregnancy. (Kemenkes RI, 2019) The MCH handbook can be used for recording maternal and child health, implementing health monitoring, and providing communication facilities by health workers and patients. The information contained in this MCH book is in the form of information on nutrition, maternal and child health, cards for pregnant women, KMS for infants and toddlers, and records of services by health workers written so 528 www.ijrp.org IJRP 2022, 92(1), 528-535; doi:.10.47119/IJRP100921120222748