Shortly after finishing the sessions, comments emerged in the press about the possibility that the record label DGC Records would not release the album in its original state, considering it uncommercial. Although Nirvana denied these claims, they were not entirely satisfied with Albini's result. Given his refusal to make further changes, the band turned to Scott Litt to make minor adjustments and remix singles like "Heart-Shaped Box" and "All Apologies". Despite not reaching the sales figures of Nevermind, In Utero debuted at number one on the Billboard 200 and was praised for its marked departure from its predecessor. The album has been certified multi-platinum by the RIAA, selling over fifteen million copies worldwide.
The path to In Utero began after the commercial explosion of Nevermind in 1991. Despite initial expectations of modest sales, Nevermind became a phenomenon, popularizing the Seattle grunge sound. However, the members of Nirvana expressed their dissatisfaction with the album's production, calling it too refined. Cobain had already anticipated in 1992 that the next album would show "the two extremes" of their sound, with rougher tracks and others more melodic, seeking to move away from the unidimensionality of Nevermind. The creation process was delayed by tours and the wait for the birth of his daughter, Frances Bean Cobain, which led DGC Records to release the compilation Incesticide in late 1992. In previous interviews, Cobain had expressed his interest in working with both Jack Endino, who produced their debut Bleach, and Steve Albini. In fact, in October 1992, they recorded demos with Endino in Seattle, many of which would be reworked for In Utero. They also made demos during a tour in Brazil in January 1993, from which the improvised "Gallons of Rubbing Alcohol Flow Through the Strip" emerged, included as a hidden track on some international editions of the album.