Created by writer Mark Millar and artist Steven McNiven, she first made her appearance during the 2006 crossover event Civil War #1 as an anti-superhero protester modeled after activist Cindy Sheehan.
Marvel editor-in-chief Joe Quesada has stated that, at one point during the planning of Civil War, Miriam Sharpe was intended "to shoot Cap right after he puts his hands up to be handcuffed".