Peter Kovacs teaches part-time at a community college and tends bar to make ends meet. When a newborn baby is found alive in a trash can in an alley next to the school, Peter tries to find out what happened. A parallel narrative—one that eventually intersects the main story—recounts a Japanese high school student's growing alienation from his life of pointless striving. Birth Pangs is a literary mystery about abandonment, home, and family triggered by the discovery of a baby in an alley.