If you are referring to ectopic pregnancies by “the other situation you speak of”, the occurance is about 1% to 2% in developed countries, so to say it is “pretty much fictional” and “almot never occurs” is incorrect.
Many people will call a resolution of an ectopic pregnancy an “abortion”, but it is not done to abort the child, but truly to save the life of the mother.
The problem is that most people are not truly capable of understanding the moral and ethical difference that unintended consequences have.
And an honest discussion about abortion, abortion providers, and the laws of this country are that “the live of the mother” is nowhere set out in the laws permitting abortion, so what the law privodies is both an operation due to an ectopic pregnancy, and anything else and nothing else as the underlying issue of “health of the mother”. In other words, what truly could be saving the life of the mother gets put in the same category as “saving her any emotional, physical or economic pain”.