Thinking about having a baby, you with your literary bent? Forget Dr. Spock. Forgo "What to Expect." Consult fiction, that nonfactual repository of wisdom, instead. Read Jenny Offill's "Department of Speculation." Paula Bomer's "Nine Months." And if after that you still have the nerve (or, let's face it, the basic biological impulse) to undertake the worst best experience of your life, read Elisa Albert's "After Birth." It's coarse and poetic and funny as hell, full of the hard truths no one tells you beforehand, including just that: No one tells you the truth.

"Here's the problem," the narrator, Ariella, remarks: "We are taught nothing." By which she means the rudiments of living: not just birthing and nurturing babies, but growing and building and fixing things, moving through time, growing old, dying, grieving, changing, sitting still, being quiet. But it is the birthing and nurturing to which her book is most devoted, although the story blossoms into one about the larger problem of being a woman.

The basics: Ariella, a mostly happily married woman with a 1-year-old child, isolated in a small, somewhat seedy Victorian town in upstate New York, with a stalled dissertation in women's studies and the recurrent sense that she's losing her mind, meets and becomes friends (or obsessed) with Mina, a fascinating onetime bassist with an '80s band called the Misogynists, who's moved into the neighborhood to have her own baby — which she promptly does, with complications that give Ariella an opening.

Shared breastfeeding ensues, along with traded stories of childbirth and girlhood and an intimacy that allows for intense reflections on sexuality and motherhood. Throughout, Ariella unfolds her own troubled history as the child of a horrible mother ("Bitch from hell, I scrawled in my diary at nine"), dead early of cancer, herself the late and only child of a woman who'd "survived" a concentration camp as a sex slave to its Nazi overlords.

The novel proceeds as a provocative meditation — sometimes verging on manifesto — on sexuality, childbirth, motherhood and the friendship of women. Alluding to feminist poet and essayist Adrienne Rich, Ariella says, "The work of childbearing, done fully, done consciously, is all-consuming. So who's gonna write about it if everyone doing it is lost forever within it?" Well, Elisa Albert, apparently. And if her aphoristic style occasionally gives way to the telegrammatic, or the narrative becomes disorientingly impressionistic, or the narrator's rage about C-sections and social niceties swamping breastfeeding overwhelms her sympathy, it all makes perfect sense and is finally enlightening, sharply moving and true — and you will never again be able to say, as Mina does, of the love-hate, body-mind chaos of childbearing, "Why doesn't anyone talk about this?"

Ellen Akins is a writer in Wisconsin. She teaches in the MFA program at Fairleigh Dickinson University.