A picture of a White House meeting with lawmakers about a new healthcare bill affecting access to pregnancy and maternity care shows 25 men discussing the reforms – and not a single woman.
Even more men are partly visible in the peripheries of the image, which was shared on Twitter by Vice President Mike Pence.
Women’s health charity Planned Parenthood pointed out this anomaly, writing on the social network: “Here’s the picture of the leaders negotiating away birth control, maternity care and abortion. Notice anything?”
Donald Trump met the conservative Freedom Caucus, an all-male group of 30 Republican House representatives, to discuss an amendment to the bill designed to repeal Obamacare.
“Appreciated joining [Donald Trump] for meeting with the Freedom Caucus again. This is it. #PassTheBill,” wrote Mr Pence.
A vote on the bill was scheduled to take place yesterday, but has been delayed to today because critics from the left and right were reluctant to support it.
One of the key sticking points for conservatives is the requirement for health insurance companies to cover a list of 10 “essential health benefits”.
These include basic reproductive health care such as pregnancy, maternity and newborn care, as well as screening for diseases including breast and cervical cancer and services for mental health, drug abuse and chronic disease management.
Republicans say forcing insurers to provide this care limits freedom of choice and pushes up premium prices, but critics say it will make maternity care more expensive and less freely available.
“This policy is going to murder poor women,” wrote journalist Kelly Weill on Twitter, citing a detail of the amendment to the bill proposed by Republicans in an attempt to get conservative House members on board.
The amendment would allow states to take away insurance from new mothers who fail to find a job within two months of giving birth, restricting their access to check-ups, education programmes and screening for post-natal depression, reported Slate.
Another photograph of the meeting tweeted by Mr Trump’s special assistant Cliff Sims, showing a standing ovation when the President entered the room, 28 men were visible and one woman, Kellyanne Conway.
Friday’s vote represents a gamble with monumental political stakes, as rebellions by conservatives and moderates, many of whom oppose the bill because public support for the Affordable Care Act, signed in 2010 by Mr Obama, is high in many states.
Its repeal, which is likely to leave more Americans uninsured, would also block for one year federal payments to Planned Parenthood.
The new bill also bars people from receiving tax credits to help pay premiums for plans that provide abortions.
In a debate earlier this month on the Obamacare replacement bill, a Republican House representative from Illinois said men should not have to pay for insurance for maternal care.
“What about men having to purchase prenatal care?” said John Shimkus, reported Penn Live. “Is that not correct? And should they?”
Democrat representative Mike Doyle replied: “There is no such thing as a la carte insurance”.
Medical associations, consumer groups and hospitals are opposed to the new bill or voicing misgivings, and some Republican governors say the it cuts provisions for low-income citizens too deeply and would leave many uncovered.
Republicans can lose only 22 votes in the face of united Democratic opposition.
Representative Mark Meadows, head of the Freedom Caucus, said he remained a “no” but did not answer when asked whether the group still had enough votes to kill the legislation.
One member of that group, representative Paul Gosar, said: “Everybody asked us to take a moment and reflect. Well, we’ll reflect.”