BACKGROUND: MCH book is a tool for early detection for vulnerable gravida. Meanwhile, the utilization of MCH book was still low. The target achieved for early detected was 12% out of 20% from 2011 to 2012. Based on SDKI 2012 duka, the average material mortality rate reached 359 per 100.000 live births, increased significatly from the date of SDKI 2007 which reached 228 per 100.000 live births. METHODS: This study was observational with cross sectional design. Both quatitative and qualitative data were collected. Secondary data were collectied by the availability of MCH book, midwives training, supervisions, and complete fulfillment of MCH book. Populations in Puskesmas Kedudung and Puskesmas Geger Bangkalan district. The samples were midwives with more than oneyear working and graduated from DII (diploma). The complete fulfillment of MCH book was identifiedfrom family identity, delivery preparation, gravida medical record, antenatal medical record, postnatal medical record, KMS (Booklet to Infant Nutritional Status Detection), Neonatus medical record, infact medical record, vitamin A Supplementtary. RESULT: The Complete fulfillments were in Puskesmas Geger 0.66 (category: good 0.51-1.00) and Puskesmas Kedundung 0.35 (category: loww 0.00 -0.50). Midwives' Motivations were low (50.0%) and midwives workload were high (66.7 %) at Puskesmas Geger. Midwives were highly motivatied (66.7%) and their workloads are fair. RECOMENDATION: make group of work and allocate the job desscription properly to assist midwives workload. In addition, helth office of bangkalan should give reward to those who so the work excellently.