Nirvana's third and final album, In Utero, is fondly remembered by most as an irascible rock classic. But when it was birthed 20 years ago this week — reaching stores overseas on Sept. 13, 1993, and the States a day later — it was seen as a problem child, to say the least.

There were some record company executives who'd have rather the project stayed "in utero" for a longer and more commercially productive gestation. A mountain of press about the album's supposed lack of listen-ability had already piled up in the months leading up to the blessed event, with one provocative word standing out: "unreleasable." Initial reviews and fan reaction when it did finally appear were hardly universally ecstatic, either. Was this any way for the stork to deliver what many Nirvana fans consider the band's true masterpiece?

For better or for worse, In Utero seemed then and now to be the most accurate representation of what it sounded like inside Kurt Cobain's head — i.e., a nice place to visit, but you wouldn't necessarily want to live there. He certainly didn't, as he committed suicide just six months after this recorded swan song was released.

The original title for the album was I Hate Myself and I Want to Die, which was nixed for being too obviously provocative and jokey, not too prophetic. "That's pushing it too much," said bass player Krist Novoselic at the time, according to biographer Michael Azzerad. "Kids would commit suicide and we'd get sued."

Cobain naturally drifted toward something less literal and more poetic in the end, and opted for the biologically based title and cover imagery. But for the frontman, biology wasn't just destiny, it was agony.

As Azzerad pointed out about the album in his book Come As You Are: The Story of Nirvana: “A medical theme runs through most lyrics… Virtually every song contains some image of sickness and disease, and over the course of the album, Kurt alludes to: sunburn, acne, cancer, bad posture, open sores, growing pains, hangovers, anemia, insomnia, constipation, indigestion." At the time of release, the author pointed this out to Cobain, and said, "He finds this litany hilarious. ‘I’m always the last to realize things like that, like the way I used guns in the last record,’ he says. ‘I didn’t mean to turn it into a concept album.’”

In the beginning, there was definitely a concept for In Utero, albeit a strictly sonic one: come up with something that bore as little resemblance as possible to Nevermind, the rock 'n' roll-changing triumph that preceded it by two years.

That may sound counter-intuitive, and by most standards — certainly the record company's — it was. But "if it ain't broke, don't fix it" was the last maxim that would have occurred to the contrary trio, who fretted that Nevermind had represented a sellout.

Nowadays, the surviving members of Nirvana are just fine with their landmark album. "It took me 20 years for me to realize Nevermind was a great record,” Novoselic told Mojo this year, “and it was.”

But at the time, their attitude bordered on ashamed. In 1993 Novoselic went so far as to describe In Utero as "a litmus test towards our audience…In terms of mainstream appeal, it won’t have the glossiness of Nevermind.” Cobain's hatred for the sound of the album that had made him beloved to millions was more pronounced. "I never listen to Nevermind," he said in '93." I haven’t listened to it since we put it out. That says something. I can’t stand that kind of production and I don’t listen to bands that do have that kind of production, no matter how good their songs are." The record company, he predicted, was "going to eat my s***. Of course, they want another Nevermind, but I’d rather die than do that."

It was partly a reaction to the sheen that producer Butch Vig had put on that breakthrough album, which had genuinely unnerved their ears, and partly an anxious response to success in general. "The first thing we did when Nevermind went huge is cancel everything and go into hiding," then-drummer Dave Grohl told the Observer this month. "U2 and Guns N' Roses wanted us to tour with them, Lollapalooza wanted us to headline. All these offers, and we thought, 'Let's just go home and take the ball with us.' Like, game over."

Their response when it came time for the follow-up was to contact producer Steve Albini, renowned for being uncompromising in his work with a host of no-budget indie bands as well as for helming a couple of more successful albums the band admired by the Pixies and Breeders. A soon-to-be-released deluxe reissue of In Utero reproduces a letter Albini sent Nirvana, after they'd agreed to work together but before they met: "I think the very best thing you could do at this point is exactly what you're talking about doing: bang a record out in a couple of days with high quality but minimal production, no interference from the front-office bulletheads. If that is indeed what you want to do, I would love to be involved."

He sounded pretty enthusiastic for a guy so indie he had once dismissed Nirvana as "R.E.M. with a fuzzbox."

The close of Albini's early 1993 letter: "If a record takes more than a week to make, somebody's f***ing up."

By that rigid standard, the making of In Utero was pretty f***ed up: It took almost two weeks.

They entered Pachyderm Studios in Cannon Falls, Minnesota on February 12, 1993, and the threesome lived as well as worked at the compound through the 26th, with no visitors from the record label and really only one emissary from the outside world, a lone cameo by Courtney Love. There were no drugs around, Grohl told NPR's "All Songs Considered" this month. "I had stopped smoking pot, like, in 1990. So I was a sober guy. Plus, where the hell are you going to get weed in the middle of winter outside of Minneapolis? We weren't making a record at Tuff Gong! I mean, we were focused; that's the funny thing. I think maybe the reputation that Nirvana has is that we were three Sid Viciouses, Viciousuzzes...how would you pluralize that? Viscii?"

Albini had the band record the rough tracks together, as a unit, with partitions to keep the sounds distinct. Novoselic said that after rehearsals, most of the tunes went down in one, two, or three tracks at most. Cobain mostly overdubbed his vocals toward the end of the two weeks. (The demos included on the forthcoming boxed-set reissue of In Utero are largely wordless, reflecting how last-minute some of Cobain's lyric writing was.)

The band was thrilled with the results. Their label, Geffen, and management company, Gold Mountain, not so much so — at least according to accounts from the period, and Albini's residual bitterness to this day over the initial reaction.

"The grown-ups don't like it," Cobain groused to Azzerad in those pre-release months, passing along adjectives like "unlistenable" and "not up to par." Soon the press picked up on the tension between Nirvana and their business interests. "Record Label Finds Little Bliss in Nirvana's Latest," read a headline in the Chicago Sun-Times in April 1993. Albini told journalist Greg Kot: "Geffen and the band's management hate the record. They considered it an indulgence when Nirvana asked to record with me. I have no faith this record will be released... It sounds different than any record made this year. It's not a record for wimps." Albini added that the members of Nirvana "were ecstatic about the record, but every person they work for tells them it's terrible."

Newsweek wrote a story about the supposed impasse that prompted a furious response from no less a figurehead than David Geffen himself. The band took out a full-page reaction in Billboard magazine to insist there was no problem, quoting Cobain as saying: "There has been no pressure from our record label to change the tracks we did with Albini. We have 100-percent control of our music." Yet, clearly, there was fire where there was smoke. Geffen A&R exec Gary Gersh told Rolling Stone: "It’s a bunch of horses***. The band felt they should be doing some more work, and I agreed with them. I did think that the sound of the record needed some work. We asked Steve to do the work; he refused. The picture Steve paints — that some big corporate conglomerate has glopped onto Nirvana’s legs — is just not true. Kurt Cobain is like my son."

One-time manager and band confidante Danny Goldberg was also unhappy with the producer: "Steve Albini takes the position that anything he thinks is good is good, that he’s David Koresh. He is God, and he knows what’s good. And if the artist doesn’t like it, then the artist is somehow selling out because they don’t agree with his personal vision."

By this time, the band was severing itself from Albini's severe vision by having Scott Litt remix three of the songs, two of which went on the album, the other of which was used as a radio mix. Cobain went into the studio and added an acoustic guitar and overdubbed harmonies to first single "Heart Shaped Box," which would have been anathema to Albini. The vocals were turned up by 3 db's, and the bass made a little less mushy in the final mix, according to Azzerad.

Rather than a sellout, this seemed to represent a new maturity for Nirvana, recognizing that it's okay to do a little tweaking and still be okay with the ownership of your own soul.

The boxed set version of In Utero allows fans to hear several different versions of some of these tracks. You get to hear both Albini's and Litt's original renderings of the three songs they did both did separate mixes on. Moreover, Albini has done an all-new 2013 remix of the entire album, with Grohl and Novoselic fully participating. The differences may be subtle in many cases, but on "Serve the Servants," for example, Novoselic told NPR that they noticed there was an entirely different guitar solo Cobain had performed that they noticed and put on the new version in place of the familiar one.

"To be honest," Albini said recently, "the people who gave me a hard time on the initial release of that record were not in the band. I never had any real beef with the band, so it was totally comfortable working on that material again with Krist, Dave, and Pat (Smear). I never had any qualms with them and they never expressed any reservations to me about the job I did or the way I handled things with the band. Mercifully, the participation of the record label this time was purely advisory. There was no mandate that came down about how everything was supposed to be handled. I think that the record labels now realize that they’re not that good at telling musicians how to conduct their business."

But back in the day, Cobain wasn't doing a very good job of conducting his own personal business, as his heroin addiction flickered back to life.

"My body is damaged from music in two ways," Cobain told the Guardian in an interview conducted in New York on July 23, 1993, for the forthcoming album's launch. "I have a red irritation in my stomach. It's psychosomatic, caused by all the anger and the screaming. I have scoliosis, where the curvature of your spine is bent, and the weight of my guitar has made it worse. I'm always in pain, and that adds to the anger in our music. I'm grateful to it, in a way...My stomach was so bad that there were times on our last tour where I just felt like a drug addict because I was starving. I went to all these different doctors but they couldn't find out what was wrong with me. I tried everything I could think of: change of diet, pills, stopped drinking, stopped smoking. Nothing worked, and I just decided that if I'm going to feel like a junkie every morning, vomiting every day, then I might as well take the substance that kills that pain. That's not the main reason why I took heroin, but it has more to do with it than most people think."

Not that he wanted to leave the Guardian interviewer with the impression he was still hooked. "I'd taken heroin for a year and a half," he said, "but the addiction didn't get in the way until the band stopped touring about a year and a half ago. But now things have got better. Ever since I've been married and had a child, within the last year, my whole mental and physical state has improved almost 100 percent. I'm really excited about touring again. I'm totally optimistic: I haven't felt this optimistic since my parents got divorced, you know."

What the interviewer didn't know was that Cobain was late for the interview because he'd nearly overdosed that very morning.

According to Anton Brookes, who was working with the band on their British press interviews as a publicist at the time, "I went up an hour beforehand to touch base with everyone and check whether everything was okay. [Today] it wasn’t. There was obviously a massive altercation going on between Kurt and Courtney. You don’t want to get involved in a husband and wife dispute...You could hear the odd thing being smashed...I had to keep going between the rooms and the lobby, telling the journalists 'It’ll happen, but everything’s kind of running late,'" Brookes told The Fly. Come the afternoon, "We realized we should go in. We went rushing into the bathroom and slumped behind the toilet was Kurt with a syringe in his arm, blue."

OD or no OD, Cobain got himself together enough that day to eventually go down and meet the waiting journalists, including the Observer writer to whom he described his mental and physical state as "100 percent improved."

"Believe it or not, Nirvana were very professional when they needed to be," the former publicist explained — not just professional enough to carry off the British junket, but enough to play their scheduled Roseland gig that night.

Cobain was clearly alluding in much of In Utero to his problems adjusting to stardom. "A lot of what he has to say is related to a lot of the s*** he's gone through," bandmate Grohl said at the time. "And it's not so much teen angst anymore. It's a whole different ball game: rock-star angst." That was certainly reflected in the album's opening lines: "Teenage angst has paid off well/Now I'm bored and old."

But lest In Utero come off as the quintessentially navel-gazing concept album about what a drag it is to be rich and famous, most of Cobain's concerns were more universal, not to mention existential. That same opening number, "Serve the Servants," referred to the triggering crisis of his parents' divorce, saying: "I tried hard to have a father/ But instead I had a Dad/ I just want you to know that I/ Don't hate you any more." By song's end, he was self-conscious enough about how narcissistic this might all seem to add, in the coda: "The legendary divorce is such a bore.”

And he could certainly be an empath, as evidenced by "Heart Shaped Box," which Cobain said had a lot to do with childhood cancer. "Every time I see documentaries or infomercials about little kids with cancer, I just freak out," he told Azzerad, talking about the inspiration for that single. "It affects me on the highest emotional level... Anytime I think about it, it makes me sadder than anything I can think of. Whenever I see those little bald kids..." Azzerad wrote that Cobain choked up with tears and his red face became silent for a half-minute before he could continue.

Of course, in recent years, Courtney Love has claimed that "Heart Shaped Box" really was about her genitalia.

On April 5, 1994, with fans realizing even more that In Utero was not just a decent followup but a new high-water mark for Nirvana, Cobain shot himself to death. Perhaps the most prophetic line on that last album was an overlooked one: "You can't fire me because I quit."