evidence: It is widely assumed that induced abortion is sometimes necessary to preserve a pregnant woman’s life or health. Yet, while it is true that ending pregnancy is sometimes required to achieve this, it need not be with abortive intent: first, because the death of the fetus provides no additional therapeutic benefit to terminating a pregnancy by early delivery, and, second, when a pregnancy is terminated without feticidal intent in order to save the mother’s life, it is reasonable to consider this to be nonabortive. Because there is a way of ending a life-threatening pregnancy whereby fetal death occurs outside of intention, and because abortion is defined as intentionally causing fetal death, abortion is never medically necessary. This chapter considers some of the many objections to this thesis, as well as its ethical implications. By defining abortion, deriving the concept of medical necessity from abortion law, and considering practical objections, the first half of this chapter shows that abortion is never medically necessary. The second half elaborates on the relationship between fetal death and intention, considering some of the ethical implications of the distinction between intentional fetal killing and fetal death as a side effect of intended action.