Scarred Womb

The Scarred Womb is one of the environments in Chapter 4 added in Afterbirth. The theme of the Scarred Womb is wounded and scarred tissue, grafted skin, and early stages of decay. The floor looks much like a failed surgery, with stapled skin being plastered onto the womb's walls being this floor's alt. backdrop. Most new enemies featured in The Scarred Womb are damaged and grievously injured variations of other enemies. Rocks have a chance to be replaced with Red Poop.

The Scarred Womb's alternate floors are the Womb and the Utero.

The Scarred Womb is unlocked by defeating It Lives 30 times.

Killing Dogma and The Beast also increases this tally, as does Mausoleum's version of Mom's Heart.

Monsters

Entity	ID	Description
Baby	38.0	Slowly floats towards Isaac and fires a blood shot at him. Occasionally teleports and reappears elsewhere.
Boil	30.0	Stationary enemy that decreases in size when hit, but regenerates to its full size until fully destroyed. Fires multiple short-ranged blood projectiles in random directions when fully swollen.
Walking Boil	88.0	Does not shrink or regenerate. Walks around aimlessly and fires multiple short-ranged blood projectiles in random directions.
Bony	227.0	Wanders around the room and throws a bone at Isaac when he is in sight.
Death's Head	212.0	Invulnerable enemy that moves diagonally around the room, dealing contact damage. Dies when the room is cleared.
Flesh Death's Head	286.0	Moves diagonally around the room, dealing contact damage. Releases 6 blood shots in all directions upon death. Can be killed, but also dies when the room is cleared.
Brain	32.0	Slowly crawls around the room, leaving a trail of Red Creep.
MemBrain	57.0	Slowly moves around the room, occasionally hopping and firing 8 large blood shots in all directions. Splits into 2 Brains upon death.
Clotty	15.0	Randomly wanders around the room, firing 4 blood shots in the cardinal directions.
I.Blob	15.2	Randomly wanders around the room, firing 8 shots in all directions.
Mega Clotty	282.0	Slowly moves around the room, occasionally hopping and either firing 6 blood shots in all directions, leaving a puddle of Red Creep, or spawning a Clotty or a collapsed Globin. Splits into two Clotties upon death.
Dip	217.0	Slowly dashes in random directions, dealing contact damage.
Squirt	220.0	Dashes towards Isaac and deals contact damage. Spawns 2 Dips upon death.
Dinga	223.0	Slowly moves around the room, occasionally hopping to spawn Dips or fire 8 Brown shots in all directions. Splits 2 Squirts upon death.
Dople	53.0	Mirrors Isaac's movements and fires blood shots at the same time as Isaac. Can be damaged by spikes.
Embryo	77.0	Aimlessly hops around the room, dealing contact damage.
Eye	60.0	Slowly turns towards Isaac and fires a Technology laser at Isaac if he stands still or is too slow.
Pale Fatty	208.1	Slowly walks towards Isaac. Occasionally farts and shoots 6 blood shots in all directions. Has a chance to turn into a Blubber upon death.
Fat Sack	209.0	Slowly walks towards Isaac. Occasionally leaps off-screen and attempts to land on Isaac, leaving a puddle of Red Creep and shooting 6 blood shots in all directions where it lands. Has a chance to turn into a Blubber upon death.
Blubber	210.0	Walks around aimlessly and randomly spews a cluster of blood shots in all directions. Has a chance to turn into a Half Sack when killed.
Half Sack	211.0	Wanders around aimlessly and leaves a trail of Red Creep.
Fly	13.0	Hovers in place. Does not deal contact damage and is harmless, but can turn into Pooters if they stay around Poop.
Attack Fly	18.0	Red fly that follows Isaac and deals contact damage.
Eternal Fly	96.0	Invulnerable fly that circles Corny Poop and various monsters. Deals contact damage. Turns into a vulnerable Attack Fly after the object or monster it circles is destroyed.
Moter	80.0	Follows Isaac, similar to Attack Flies. Deals contact damage. Splits into 2 Attack Flies upon death.
Pooter	14.0	Slowly drifts toward Isaac, occasionally firing a single blood shot at him. Does not deal contact damage.
Full Fly	249.0	Flies toward Isaac erratically, dealing contact damage. Releases 6 bullets in all directions upon death.
Red Boom Fly	25.1	Flies across the room in straight diagonal lines, dealing contact damage. Creates a ring of 6 blood shots upon death.
Sucker	61.0	Flies slowly towards Isaac, exploding into 4 shots in the cardinal directions upon death.
Spit	61.1	Flies slowly towards Isaac, firing an Ipecac shot towards Isaac upon death.
Fred	59.0	Hops out of the ground and burrows elsewhere, firing 4 blood shots in the cardinal directions. Occasionally fires red Ipecac shots at Isaac.
Globin	24.0	Chases Isaac, dealing a full heart of contact damage. Upon taking enough damage, it collapses into a pile of goo, which can be killed. Will regenerate after a short period of time if not killed quickly.
Gazing Globin	24.1	Quickly chases Isaac, dealing a full heart of contact damage. Upon taking enough damage, it collapses into a pile of goo, which will slide away from Isaac and can be killed. Will regenerate after a short period of time if not killed quickly.
Grub	239.0	Erratically moves around the room like Larry Jr. and charges at Isaac when he gets within its line of sight. Spawns Maggots, Chargers, or Spitties upon death, one for each of its segments.
Gurgling	237.0	Charges towards Isaac when he lines up with them, leaving a trail of Red Creep and shooting 6 blood shots.
Guts	40.0	Attaches itself to a wall or obstacle and rolls around it.
Scarred Guts	40.1	Attaches itself to a wall or obstacle and rolls around it, leaving a trail of damaging Red Creep.
Mama Guts	57.1	Slowly moves around the room, occasionally hopping and firing 8 large blood shots in all directions. Splits into 2 Guts upon death.
Homunculus	228.0	Starts attached to the wall or an obstacle. After a while, it detaches, shooting 6 blood shots in all directions, leaving a puddle of Red Creep and chasing Isaac. If it dies while still attached, it will still leave a puddle of Red Creep.
Leech	55.0	Quickly charges towards Isaac when he gets in its line of sight.
Pacer	11.1	Walks aimlessly around the room.
Lump	56.0	Fires 3 spread blood shots at Isaac when he gets in its line of sight. Will burrow underground and reappear elsewhere after firing.
Charger	23.0	Slowly moves around the room, charging at Isaac when he gets in its line of sight.
Mask + Heart	93.0	The Mask is invulnerable and moves around erratically, charging at Isaac when he lines up with it. The Heart avoids Isaac and fires 4 blood shots in the cardinal directions when Isaac gets near. Killing the Heart will automatically kill the Mask.
Maw	26.0	Slowly floats towards Isaac, firing a blood shot at him when he is in their range.
Red Maw	26.1	Floats quickly towards Isaac and releases 4 blood shots in the cardinal directions upon death.
Mr. Maw	35.0	Walks towards Isaac and attacks by launching its head towards him. Turns into a Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Swinger	216.0	Slowly moves towards Isaac as its head swings around its base. Upon death, spawns a Maw or a Globin depending on which part is killed.
Mom's Hand	213.0	Falls from the ceiling. If it lands on Isaac, it deals damage and teleports him back to the spawn room of the floor. Entering a room containing Mom's Hand will warn Isaac with Mom's laugh.
Mom's Dead Hand	287.0	Falls from the ceiling. Upon landing, it spawns several rock waves that travel outwards. Spawns several spiders upon death. Entering a room containing Mom's Dead Hand will warn Isaac with Mom's laugh.
Nerve Ending	231.0	Static enemy which acts as a meat shield.
Oob	224.0	When Isaac lines up with it horizontally, it charges across the room once. When Isaac is not horizontal to it, it spawns Brains.
Tumor	229.0	Moves around the room diagonally, occasionally firing 6 blood shots in all directions. Fires more often upon getting damaged.
Para-Bite	58.0	Moves towards Isaac, dealing contact damage. Can burrow underground and reappear elsewhere.
Scarred Para-Bite	58.1	Moves towards Isaac, dealing contact damage and firing a short-range blood shot at him. Can burrow underground and reappear elsewhere.
Cod Worm	221.0	Stationary enemy that hides in a shell and spews a burst of blood shots if shot at. Only vulnerable when it pops its head out.
Host	27.0	Stationary enemy that is normally invulnerable. Raises its head up when Isaac gets close, revealing a fleshy stem that can be damaged. Upon raising its head, it will fire 3 blood shots in a spread and lower its head again.
Red Host	27.1	Stationary enemy that can be damaged even when its head is lowered. Fire 5 spread blood shots when it raises its head.
Flesh Mobile Host	247.0	Acts like the Red Host, but follows Isaac and deals contact damage.
Meatball	290.0	Slides around the room. If Isaac is in sight, it will stop to spew a fountain of short-range blood shots in all directions or to spit a line of damaging Red Creep towards Isaac. Spawns a Host upon death.
Rotty	226.1	Slowly walks towards Isaac, leaving short-lasting Red Creep behind itself. Spawns a Bony or two Attack Flies upon death.
Crazy Long Legs	207.0	Chases Isaac, dealing touch damage. Occasionally stops to spit 8 blood shots in all directions.
Small Crazy Long Legs	207.1	Chases Isaac, dealing touch damage. Occasionally stops to spit 4 blood shots in the diagonal directions.
Round Worm	244.0	Pops out of the ground in random locations and spits a blood shot at Isaac if he is in sight.
Ulcer	289.0	Pops out of the ground in random locations and spawns a Dart Fly if Isaac is in sight. Fires a blood shot after spawning 6 Dart Flies.
Spider	85.0	Erratically moves around the room. If Isaac gets close to it, it chases him, trying to deal contact damage.
Big Spider	94.0	Erratically moves around the room. If Isaac gets close to it, it chases him, trying to deal contact damage. Spawns two Spiders upon death.
Wall Creep	240.0	Crawls along walls to try to line up with Isaac and shoots three blood shots in a line.
Blind Creep	242.0	Randomly crawls along walls and shoots three spread blood shots.
Rage Creep	241.0	Slowly crawls along walls to try to line up with Isaac and shoots a Brimstone laser.
Tumor	229.0	Moves around the room diagonally, occasionally firing 6 blood shots in all directions. Fires more often upon getting damaged.
Vis	39.0	Randomly wanders around the room. Pauses to charge and fire a Brimstone laser when Isaac gets in its line of sight.
Double Vis	39.1	Randomly wanders around the room. Pauses to charge and fire a Brimstone laser which fires from both sides when Isaac gets in its line of sight.
Scarred Double Vis	39.3	Randomly wanders around the room. Pauses to charge and fire a Brimstone laser which fires from all four cardinal sides when Isaac gets in its line of sight.
Chubber	39.2	Randomly wanders around the room. Pauses to fire a Charger that deals one heart of damage when Isaac gets in its line of sight. The Charger is invulnerable, blocks Isaac's tears, has limited range, and flies back to the Chubber.
Red Ghost	285.0	Disappears, then reappears near Isaac and fires a brimstone laser.
Slide	44.1	Quickly slides towards Isaac when he gets in its line of sight, then moves slowly back to its original position. Cannot be destroyed.
Wall Hugger	218.0	Moves around the room like Guts, damaging Isaac by contact. Cannot be destroyed.
Stone Grimace	42.0	Stationary and invulnerable monster that occasionally fires a blood shot at Isaac. Stops firing when room is cleared.
Gaping Maw	235.0	Stationary and invulnerable monster that sucks Isaac towards it, along with Isaac's tears and enemy projectiles.
Broken Gaping Maw	236.0	Stationary and invulnerable monster that sucks Isaac towards it, along with Isaac's tears and enemy projectiles. Alternates between active and inactive every couple of seconds. Has a stronger attraction power than a regular Gaping Maw.
Stone Eye	201.0	Stationary and invulnerable monster that constantly rotates and fires a flickering Technology laser. Stops firing when the room is cleared.
Suction Pitfall	291.1	Invulnerable and stationary enemy which sucks Isaac towards itself. Isaac falls into it when walked over, taking damage and popping back out after a short delay.
Fistuloid	308.0	Flies towards Isaac in an erratic waving motion, periodically firing a blood shot towards Isaac that also knocks itself back. Upon death, fires a worm that flies off screen.
Leper	310.0	Alternating between walking towards and running away from Isaac. Releases a Leper Flesh each time it takes enough damage. At low health, constantly chases Isaac and leaves behind damaging red creep. Spawns a Leper Flesh and Gusher upon death.
Leper Flesh	310.1	Floats slowly toward Isaac and fires a predictive projectile at him upon death.
Ministro	305.0	Hops around randomly and hop towards Isaac when he gets close, occasionally spitting out a cluster of disorganized shots.
Poison Mind	301.0	Slowly crawls/floats around the room diagonally, leaving a trail of damaging green creep. Explodes upon death.
Mr. Red Maw	35.2	Walks towards Isaac and attacks by launching its head towards him. Turns into a Red Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Nerve Ending 2	231.1	Static enemy which whips at Isaac if he gets too close.
Stoney	302.0	Chases Isaac and blocks tears, but does not deal contact damage. Temporarily pauses in exhaustion after a certain amount of time. Invulnerable; dies when the room is cleared.
Cross Stone Shooter	202.10	Stationary and invulnerable monster that continuously fires shots in four directions, alternating between cardinal and ordinal.
Portal	306.0	Spawns various enemies from the current floor until it either vanishes or is killed.
Faceless	827.0	Wanders around the room, rarely firing a radial burst of six shots. Chases Isaac and fires shots more frequently after taking damage.
Mask II + 1/2 Heart	93.1	The Mask is invulnerable and moves around erratically, charging at Isaac when he lines up with it. The Heart avoids Isaac and fires 4 blood shots in the ordinal directions when Isaac gets near. Killing the Heart will automatically kill the Mask. If there are more than one 1/2 Heart in the room, they will fire blood shots between each other.
Needle	881.0	Pops out of the ground and lunges towards Isaac, dealing contact damage.
Triple Grimace	42.2	Stationary and invulnerable monster that occasionally fires a triple shot at Isaac. Stops firing when room is cleared.

Degraded Bosses:

Name	ID	Notes
Blastocyst	74.0	Small- and Medium-form only
Chub	28.0
Dingle	261.0
The Duke of Flies	67.0
Envy	51.0
Fistula	71.0
Gemini	79.0
Gluttony	49.0
Gurdy Jr.	99.0
Gurglings	237.1
The Haunt	260.0
The Hollow	19.1
Larry Jr.	19.0
Loki	69.0
Lust	47.0
Mega Fatty	264.0
Mega Maw	262.0
Monstro	20.0
Peep	68.0
Pin	62.0
Polycephalus	269.0
Sloth	46.0
Widow	100.0
Wrath	48.0
The Wretched	100.1

Bosses


Blastocyst	Mama Gurdy	Scolex	Triachnid


The Bloat	Teratoma	Daddy Long Legs	Death


Conquest	The Fallen	Headless Horseman	The Matriarch


Sisters Vis	Lokii	Mr. Fred

Double Trouble

Double Trouble Bosses

(Double Trouble)
Gurdy

Final Boss

It Lives will always appear in the second floor of this chapter or in the last boss room if the Curse of the Labyrinth is active.

After being killed 11 times, Mom's Heart is permanently replaced by It Lives.


Mom's Heart	It Lives

Unlockable Achievements

Eden - Complete Chapter 4.

Pop! - Beat Chapter 4 without taking damage.

Mama's Boy - Beat Chapter 4 without taking damage.

Trivia

Before the proper release of Afterbirth, the Scarred Womb was to be named "Rotten Womb".
The stitches on the walls and floor faintly resemble the Fistula boss.
Using Flush! on the scarred womb will flood the room with red liquid (likely blood) instead of water.
Previously, Mom's Heart could appear in the Scarred Womb. However, as of Booster Pack #5, since it is required to defeat It Lives 30 times to unlock the Scarred Womb, Mom's Heart can no longer appear in it.

Music

The music for the Scarred Womb is titled Cicatrix.^[1]
A cicatrix is a medical term for a scar, as well as the Latin term for "scar".
The music heard during the fight against Mom's Heart/It Lives is called Ventricide. Ventricide combines ventricle, a word that means a hollow area in an organ and is often associated with the heart, and the suffix -cide, which denotes the act of killing.