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.