Yeah I never got why the Trek writers went this direction with it. It's meant to stop the Federation from becoming the exploiters, even with the best of intentions. It's not meant as some catchall absolution of any responsibility whatsoever. TNG did this a few times and Voyager went crazy with using the Prime Directive as an excuse to let people die.
Literally the way they cite it, if I see a pregnant woman hanging from a cliff about to fall, I should let her fall because her baby might grow up to be Hitler.