Illness during pregnancy poses a significant challenge for expectant mothers, as it can lead to high levels of uncertainty, which, if not properly managed, can affect their physical, emotional, and social well-being. In this context, the ability to understand the condition, interpret symptoms, and access clear information becomes a key factor in making informed decisions and coping healthily with the pregnancy. The literature indicates that uncertainty, when not accompanied by cognitive strategies and structural support, increases biopsychosocial vulnerability and limits women’s autonomy in their care process. To analyse these dynamics, a correlational study was conducted involving 91 pregnant women attending two health centres. The majority belonged to middle socioeconomic strata and had a university education. More than half were experiencing a high-risk pregnancy, and 45.1% presented a high biopsychosocial risk, mainly associated with high blood pressure and infectious conditions. The findings showed that uncertainty is related to a lack of clarity about the condition and to symptom variability. Furthermore, significant associations were identified between cognitive ability, biopsychosocial risk, sources of structural support, and overall uncertainty. These findings suggest that biopsychosocial risk is closely linked to higher levels of uncertainty during pregnancy. Consequently, there is a need to strengthen the processes of informational, cognitive, and structural support aimed at pregnant women, particularly those who are hospitalised or have high-risk conditions. Promoting educational interventions, effective communication strategies, and comprehensive support helps reduce perceived uncertainty and encourages healthier coping in clinical settings.