Blood Relations was first produced in 1980 at Theatre 3 in Edmonton, Alberta, Canada. This was not the play's first appearance on stage, however, as Sharon Pollock often extensively revises her plays, even after the first couple of productions. The previous version was produced as My Name Is Lisabeth in 1976 at Douglas College with Pollock herself playing the role of Lizzie Borden. After significant revision, she renamed the play Blood Relations and staged it as a new work in 1980.

The play is based on historical fact: die 1892 double murder of Lizzie Borden's father and stepmother, a crime for which Lizzie herself was charged. The crime shocked the Massachusetts community of Fall River, as well as the whole nation, and citizens read with fascination reports of the trial. Lizzie was acquitted but the crime was never solved, and her innocence was questioned by the public. In contemporary times, the figure of Lizzie Borden has achieved iconic status. Many perceive her as an early feminist who did not shy from acting and thinking as an individual. It has often been theorized that, if Lizzie did in fact commit the murders, her actions were based on self-preservation, an attempt to escape from an abusive family situation.

Some reviewers of Blood Relations challenged Pollock for writing a work that failed to adequately confront feminist concerns, instead choosing to direct the play towards a more general political agenda. Pollock's work appears to be "more involved with studies of oppression in general and political processes in particular than ... in specific struggles of women," said S. R Gilbert in Contemporary Dramatists.

Blood Relations was the first full-length play Pollock produced. A published version of it, released in 1981, won her the Governor General's Award, the first time such an award was made for a piece of dramatic literature.

Controversy often followed Blood Relations, specifically in 1982 and 1983, when Pollock sued a television station for damage to her literary reputation when it decided to drop her play and develop its own script. The case was settled out of court.