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edit: already answered
The upside of it is you can use an easy character, then die with the Ankh once your build is OP and get easy unlocks for Blue Baby. The downside is that if you already have those unlocks, you don't want to use it at all because it changes your character.
The other items that behave this way are Lazarus' Rags (revives you as Lazarus), Judas' Shadow (revives you as Judas, but with a 2x damage modifier instead of his usual 1.3x), and the Missing Poster trinket, which revives you as The Lost (but only in Afterbirth or AB+, in the vanilla version its effect is ... complicated, but nothing that's directly useful).
Thanks for clarifying, I was kind of confused...