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I beat Mom for the first time yesterday and continued into the Womb on a second playthrough. I was doing pretty well (playing Cain, had 6-7 hearts, maxed out tears, high damage, 99 coins and keys, etc.), but noticed a significant difficulty difference in the Womb.

What is the differences between the pre-Mom levels (the Basement, Caves, and Depths) and the post-Mom levels (I know I took more damage, at least)?

I didn't find any shops or item rooms in one and a half levels in the Womb - is that a coincidence, or do I need to just hope all my items from before Mom can get me through the rest of the game?

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The game gets even harder!? Mother of god. –  Prinny Brocka Mar 28 '12 at 15:53
    
@BenBrocka Oh, it gets even harder after that as well, but I don't want to spoil the epic battle. –  lunboks Mar 28 '12 at 15:56
    
@BenBrocka from what I understand, this is just the tip of the iceberg. Between It Lives! and Satan himself...abandon all hope. –  Ian Pugsley Mar 28 '12 at 15:57
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up vote 8 down vote accepted

For one thing, as you have noticed, all monsters will do a full heart of damage, even those that did less in previous dungeons (unless you have the Wafer, which grants damage resistance). This applies to Blood Donation Machines as well.

Some special rooms (the Shop, and the Item Room) aren't present here, but you can still get Arcades and Gauntlet Rooms. The secret room can also contain an arcade machine.

The Womb is also the first area to have bosses from previous dungeons in regular rooms.

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