The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Focus group discussions were conducted in both countries, and a Stigmatizing Attitudes, Beliefs, and Actions scale was created. It captures three important dimensions of abortion stigma: negative stereotypes about men and women who are associated with abortion, discrimination/exclusion of women who have abortions, and fear of contagion as a result of coming into contact with a woman who has had an abortion. It provides a validated tool for measuring stigmatizing attitudes and beliefs about abortion in Ghana and Zambia and has the potential to be applicable in other country settings.