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yeah birthright is trash it doesn't do anything on lilith so birthright is universally a trash item
On a serious note, shard of glass isn't too special. Sure, there is an argument for Tainted Maggie, but there's also a counter argument. Tainted Maggie already loses health down to two hearts, having health being lost beyond that isn't worth IMO. Endgame bosses also become a nightmare, since you can't get health to stop the bleeding. Overall, it has uses, but the backlash can be too hard to justify the pros.
why does everyone see shard of glass as an item that ONLY bleeds you out? do they not see the blood bullets? do they not see the heart drops that can make you break even on health?
shard of glass is probably staying as is, ie. useless and detrimental in the vast majority of situations
IMO 25% chance for red-heart upon taking damage on it's own would be too good, especially with how common Old Bandage is now. There are always heart generators too, like Little C.H.A.D. (though i haven't run into C.H.A.D. outside of boss rush in ages) and Glass Jar and Moving Box have more reasons to exist.
Still, they should've went this item being a guarantee (or almost one) when breaking the mirror on the alt-path, like they might have originally planned. Seemingly bad items are the best, when you can make them consistently appear in runs.