A room full of white men met on Thursday to decide the fate of maternity coverage for millions of women in the US.
One of the major adjustments would be no longer requiring insurance companies to offer maternity care in all health plans.
Another photo, tweeted by Trump’s social media director, showed two women standing in the background:
The Affordable Care Act, nicknamed Obamacare, created a list of 10 essential health benefits that all health insurance plans must cover, including pregnancy, newborn and maternity care.
Before the act became law in 2010 the insurance market was a bleak place for women.
Women often had to pay more than men for the same coverage and it was completely legal for insurance companies to refuse coverage to women who were pregnant or might become pregnant in the future.
Trump wants to repeal and replace Obamacare.
Pence’s image was quickly circulated online, with many pointing out the unfairness of so many privileged, white men deciding the fate of millions of women in the US:
It is not the first time that Trump’s administration has discussed, or even implemented, legislation affecting women’s bodies without a female in sight.
Earlier this year Trump signed an anti-abortion executive order surrounded by men.
In one of his first acts as President, he reinstated the “global gag rule” that bans American money from going to international health organisations that counsel on abortion as a family planning option.
American money helps 27 million women access contraceptives, with the US Government spending about $600 million a year on international assistance for family planning and reproductive health.
The funding that better informs poor women on family planning options.
As trump signed the order, he was flanked by a group of men including his vice-president - and abortion rights opponent - Pence.
The Affordable Care Act remains a contentious issue in the US.
Many Republicans argue men should not have to pay for things like maternity care, but experts worry that if insurance companies are given the option of offering expensive services like maternity care, it will become a race to the bottom where that coverage, once again, becomes scarce.
“Stripping guaranteed maternity care is a pregnancy tax, pure and simple,” she said.