Background: Ireland’s General Practitioner-led abortion care system was introduced in 2019 and integrated into existing primary care infrastructure. Objectives: To examine the enabling environment that translated abortion legislation into service delivery. The review identifies barriers and facilitators from the perspectives of abortion seekers, providers, and the healthcare system. Search Strategy: A systematic literature search was conducted in March 2024 across EBSCOhost, PubMed, the Cochrane Library, and Medscape. Of 150 citations screened, 41 met inclusion criteria. The review followed JBI’s convergent integrated approach. Selection Criteria: Eligible studies addressed the operationalisation of abortion care in Ireland, including barriers and enablers. Inclusion required methodological rigour and relevance. No language restrictions applied. CASP, MMAT and JBI tools facilitated appraisal. Data Collection and Analysis: Data were extracted using JBI tools. Quantitative findings were “qualitised” into narrative form and synthesised with qualitative data. Thematic integration was performed across three domains: abortion seekers, providers, and the healthcare system. Key grey literature, including the HSE-commissioned UnPAC study, was also reviewed and informed thematic synthesis. Findings were included if supported by credible or unequivocal evidence. Main Results: Abortion seekers require individualised, compassionate care. Social disadvantage amplifies harm within rigid legal constraints. Providers included enablers and direct deliverers; supporting individual pioneer champions was crucial. Criminalisation and absence of safety zone legislation were chilling factors. Key enablers included hospital support, clinical guidelines, START training, and value clarification workshops. Hospital settings engender more layers of stigma, conscientious objection, and medicolegal complexity. Conclusions: A collaborative, evidence-based service has been implemented, but legislative limitations and persistent qualitative barriers remain. Funding: No funding was received for this study.