<![CDATA[The MCH handbook is a tool for recording and monitoring maternal and child health and for maternal and child health education. It can be used in all health facilities, but there is no data on the relationship between the use of the MCH handbook and the selection of birth attendants in high-risk pregnant women. This research aims to determine the effectiveness of the MCH handbook in selecting helpers for high-risk pregnant women. This was an observational analytic study with a case-control design. The respondents were 101 postpartum mothers selected by purposive sampling, consisting of 41 cases (mothers with high-risk pregnancy) and 60 controls (mothers without risk factors). Data were collected through interviews using questionnaires and observation. Data were analyzed using the Chi-square test or Fisher's exact test, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Most mothers were in the non-risk age group (64.4%), had further education (81.2%), had risk parity (51.5%), and made good use of the MCH handbook (66.3%), while 13 mothers (12.9%) gave birth with non-health workers. Maternal age (p < 0.001; OR = 34.10), education (p = 0.001; OR = 5.70), and parity (p = 0.005; OR = 3.23) were associated with high-risk pregnancy, whereas hemoglobin level (p = 0.986) and MCH handbook use (p = 0.607) did not differ between cases and controls. Maternal age (p = 0.060), education (p = 0.066), parity (p = 0.073), and hemoglobin level (p = 0.743) were not significantly associated with the choice of birth attendant, whereas poor use of the MCH handbook was (Fisher's exact test p = 0.030; OR = 3.82; 95% CI 1.14–12.76; r = 0.221). The use of the MCH handbook is effective in helping high-risk pregnant women select a birth attendant; mothers who made poor use of the handbook were almost four times more likely to give birth with non-health workers.]]>
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