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He can still be very strong with the right synergies.
The bombs are affected by your actual damage now. They won't be as powerful as regular bombs.
In return though, they can become more powerful and there's many more bomb synergies.
It took me around 25-30 bombs to kill the cage despite all 7 bars filled in on damage and then getting eve's mascara on top of that (which is a pretty hefty damage up) in my last run using dr fetus - it doesn't even remotely compare to the original even with quite a few damage ups. The cage is a tank, but 25-30 bombs to kill something by end game with a significant amount of damage ups is kinda silly, they don't exactly fire fast. If not for dark bum+lil chad+contract from below+humbling bundle+several other defensive items+strong orbitals keeping me alive I'm pretty sure dr fetus would've cost me that run in the end. I actually used the orbitals as weapons instead in some rooms because it was both faster and just as safe due to the enemy types. =\
It has several buggy interactions too I noticed - I got ludo then dr fetus and dr fetus had both piercing+spectral effects despite no items granting them, presumably it got them from ludo. Later in the same run, I lost the spectral effect (I'd rather lose the piercing one, spectral is far less counterproductive with dr fetus..) when picking up other items that granted neither effect. Hot bombs and butt bombs also both have absolutely no effect on dr fetus bombs, and dr fetus bombs don't count as bombs at all for chub/chad/etc either.
It did seem to do more damage, but it did help that I could fully use any tear ups I found because of the lack of self damage from the tears ipecac somehow caused. Though some enemies still didn't die that quickly, it did make it do way more damage than it had before.
It's easier to use without piercing now as it blocks enemies a lot better than before, but with piercing it's still a nightmare (and there's several new items that grant piercing too, most of which are tied with other useful stat ups such as dmg up from death's touch) to use on anything fast, especially if it actively chases you. It's also nerfed in that you don't get bobby bombs+mr mega practically guaranteed within the next 2-3 treasure rooms like you did in the original, and mr mega was already a pretty damn hefty portion of the damage dr fetus did. There's some bomb immunity methods now sure, but they work just as well with IPECAC - which deals better damage, doesn't have the horrid delay on the explosion, poisons, and is just generally an all round better item than dr fetus now.