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Yeah completely agree the boss is a bit too common in the scarred womb. I get its the only floor it can be found on but still. I feel monstro and little horn are way to common on basement as well. I havent seen bosses like steven and gemini in ages!
The Matriarch is unlocked after you get achievement #347 -> https://bindingofisaacrebirth.gamepedia.com/Achievements . Or you have and it's just RNG as you already said.
And yeah, she is harder than Bloat. Fite me.