It appears as a large blob of internal organs, much larger than regular Guts.
Instead of attaching to an object, they slowly move around the room, eventually firing 8 large blood shots. Killing it will cause it to split into 2 Guts.
Eternal Champion Behavior
- From the Afterbirth DLC for Rebirth, Mama Guts has a chance to spawn 1 or both Scarred Guts upon death.
- From the original game, they can be found in Necropolis. They no longer appear in this chapter from Rebirth, however.