Although the singer and primary songwriter Kurt Cobain claimed that the album was "very impersonal", many of its songs contain heavy allusions to his personal life and struggles, expressing feelings of angst that were prevalent on Nevermind.

After recording finished, rumors circulated that DGC might not release the album due to Albini's abrasive and uncommercial sound.

Despite modest sales estimates,[3] Nevermind was a major commercial success, popularizing the grunge movement and alternative rock.

[5] Early in 1992, the singer, Kurt Cobain, told Rolling Stone that Nirvana's next album would showcase "both of the extremes" of their sound, saying: "It'll be more raw with some songs and more candy pop on some of the others.

[10] In Seattle in October 1992, Nirvana recorded several demos with Endino, mainly as instrumentals, including songs later rerecorded for In Utero.

[13] "Gallons of Rubbing Alcohol Flow Through the Strip" was recorded by Craig Montgomery at BMG Ariola Ltda in Rio de Janeiro, during the three-day demo session.

Cobain wanted to use Albini's technique of capturing the natural ambience of a room via the placement of several microphones, something previous Nirvana producers had been averse to trying.

In return, Albini sent Cobain a copy of the then-unreleased PJ Harvey album Rid of Me (1993) to give him an idea of the acoustics at the studio where they would record.

[24][25] Nirvana made it clear to DGC and their management company Gold Mountain that they wanted no intrusion, and did not play their work in progress for their A&R representative.

When work on a mix was not producing desired results, the band and Albini took the rest of the day off to watch nature videos, set things on fire and make prank calls.

[33] Few at Geffen or Gold Mountain had wanted Nirvana to record with Albini, and Cobain felt he was receiving an unstated message to scrap the sessions and start again.

[40] Nirvana wrote a letter to Newsweek denying any pressure to change the album and saying the author had "ridiculed our relationship with our label based on totally erroneous information".

"[9] According to Albini, In Utero made him unpopular with major record labels, and he faced problems finding work in the year following its release.

[18] He felt the sound of Nevermind was "sort of a standard hack recording that has been turned into a very, very controlled, compressed radio-friendly mix [...] That is not, in my opinion, very flattering to a rock band."

"[28] Azerrad asserted in his 1993 biography Come as You Are: The Story of Nirvana that In Utero showcased divergent sensibilities of abrasiveness and accessibility that reflected the upheavals Cobain experienced prior to the album's completion.

[47] Cobain cited "Milk It" as an example of the more experimental and aggressive direction in which the band's music had been moving in the months prior to the sessions at Pachyderm Studio.

[55] According to the psychologist Thomas Joiner, it is clear that suicide was on Cobain's mind as he worked on the album, with its lyrics illustrating "the merging of death with themes of nurturance and life, sometimes in stark and disturbing ways."

Examples include the song "Milk It", with the phrase "I am my own parasite", which according to Joiner is a "succinct and even sublime way to combine urges toward death and life."

The opening lines "Teenage angst has paid off well / Now I'm bored and old" were a reference to Cobain's state of mind in the wake of Nirvana's success.

[14] She wrote that it featured "Cobain alternating between seemingly disconnected singing and spoken-words sections, with Novoselic and Grohl providing a steady background accompaniment, punctuated by bursts of noisy guitar.

"[14] Journalist Everett True described the song's mood as "playful", with "the instruments engaging in a game of cat and mouse, almost daring each other to explode in fury".

DGC issued a new version to the stores in March 1994, with edited album artwork, "Rape Me" retitled "Waif Me", and the Scott Litt remix of "Pennyroyal Tea".

[80] A spokesperson for Nirvana explained that the band decided to edit the packaging because they wanted their music available to "kids who don't have the opportunity to go to mom-and-pop stores".

[81] In Utero also debuted at number one in the United Kingdom where according to NME, "Nirvana confirmed their status as the seminal band of the time".

[9] The band began a six-week European leg in February 1994, but it was canceled partway through after Cobain suffered a drug overdose in Rome on March 6.

[85] A third single from In Utero, "Pennyroyal Tea", was canceled in the wake of Cobain's death and the subsequent dissolution of Nirvana; limited promotional copies were released in Britain.

"[102] Entertainment Weekly reviewer David Browne commented "Kurt Cobain hates it all", and noted that the sentiment pervades the record.

"[96] NME writer John Mulvey had doubts about the record; he concluded, "As a document of a mind in flux – dithering, dissatisfied, unable to come to terms with sanity – Kurt should be proud of [the album].

"[99] Ben Thompson of The Independent commented that in spite of the more abrasive songs, "In Utero is beautiful far more often than it is ugly ... Nirvana have wisely neglected to make the unlistenable punk-rock nightmare they threatened us with.

In a 2003 Guitar World article for the album's tenth anniversary, Cobain biographer Charles R. Cross argued that In Utero was "a far better record than [Nevermind] and one that only 10 years later seems to be an influential seed spreader, judging by current bands.