What to expect when you’re not expecting

“My body, my choice” seems simple enough to most of us. But what happens when the choices one’s body makes are not the ones our head — or heart — would prefer? That’s the dilemma at the center of Elisa Albert’s fast, fiery, and often funny third novel “Human Blues.”

This novel, a headlong rush of narrative, introduces Aviva Rosner, a thirty-something musician who desperately wants to have a baby. Despite her near-constant touring, the “queen of alt-folk-punk-blues” is happily married to the stable and supportive Sam, as well as financially and professionally established with her fourth album about to be released. That album, titled “Womb Service,” “was about getting to know her body, welcoming the age of embodied womanhood in its prime … about readying herself for motherhood,” Aviva explains to the reader — not that she wants to spell this out to the “suits” at the label. But, despite sporadic attempts at every meditative practice and specialized diet that has been recommended and the best efforts of Aviva and “Sammy-Sam, her beloved manny-man,” it just isn’t happening. As the book opens, after nearly two years of trying to conceive, Aviva is about to start menstruating again.

Friends and family members are urging her to begin fertility treatments, but Aviva doesn’t want to become fodder for a burgeoning industry that she distrusts. That mistrust is mutual: “I am trained to assess the risks and benefits,” one doctor tells her. “You aren’t qualified to be making these decisions.”

Much of her wariness is based on problems from various fertility treatments that Albert documents well, from the premature and catastrophically disabled babies to the irreparable damage wrought on some women. A retired doula, who may well be a stand-in for the author, enumerates the problems throughout the system: “let’s stop pretending we’re worried about destruction on a planetary scale when we’re goddamned thrilled to override it on the cellular scale,” she says, noting “the money, the drugs, the doctors, the desperate people in this sinkhole of suffering for profit.” (The doula is also, we learn, a scholar of literature that focuses on fertility.)

Aviva’s objections go deeper, though, as she pushes back against both the medical manipulation of the female body and the societal mores that insist on certain norms, whether that norm is “have twelve babies and die in childbirth before thirty,” “[w]ait for Mr. Perfect,” “[b]e a pristine virgin,” or “let technology manipulate your body in the service of forced childbearing past innate biological capacity.” Reiterating themes from her previous works, notably her second novel “After Birth,” Albert has Aviva tie fertility treatments into the history of patriarchal control: “The point is that intelligent women have to be vigilant, because in any given era we have to say no. To everything they try to normalize for us, everything they try to sell us,” she says.

None of this is simple, and when Aviva sounds off on social media in the lead-in to the new album, she gets pushback from the trans community and its allies as well as from gay friends who have used surrogacy to achieve parenthood. In addition, over the course of the book — which is divided into nine of Aviva’s highly irregular menstrual cycles — its angry, unfiltered protagonist will have reason to examine her own motives.

Even at her most furious, Aviva is both profane and witty. (“It was inconceivable,” she laughs about her condition.) She’s also a gifted singer songwriter with a “special voice, an arresting voice, impossible to ignore. She didn’t always hit precise notes — she wasn’t some formalist, some scientist, some striver — but she sang from the gut and she meant it.” In that way, she’s like her idol, Amy Winehouse, whose massive talent and struggles with addiction occupy Aviva’s consciousness even when she’s stalking friends’ and former bandmates’ artificially conceived babies on Instagram. (The book’s title comes from a Winehouse mix tape.)

Like Winehouse, Aviva is a difficult character, lashing out at everyone at times and not very good at making amends. In fact, Albert makes little attempt at crafting Aviva into a “likeable” protagonist, but she has created a relatable and, at times, irresistible character, whose own empathy offers us insight into the life of an artist who also happens to be unhappy.

Listening to Winehouse demos, for example, Aviva interprets what she hears: “She’s trying to have fun. Please don’t let all the joy have been sapped from this process.” Aviva also relates strongly to the forces that sought to mold the dead star. “The drugs, the drinking, the eating disorder, the smoking, the love-object obsession: addictions are symptoms. The disease is … Loneliness? Disconnection? … Late capitalism?”

Over the course of the book, Aviva’s preoccupations weave together, culminating in a visit with Winehouse’s mother, one of several maternal figures in the protagonist’s life. The interaction (based on real events, the author’s note informs us) is not curative, in any sense. But as Aviva sees — and is seen by — her heroine’s mother (“Mum’s eyes stayed on Aviva longer and longer now”), she achieves something like clarity. Then it’s onto the next gig, the next recording. The cycle begins anew.

HUMAN BLUES

By Elisa Albert

Avid Reader Press/Simon & Schuster, 416 pages, $28

Clea Simon is the author, most recently, of “Hold Me Down.” She can be reached at http://www.CleaSimon.com.

What to expect when you’re not expecting

A musician confronts infertility in this fiery novel