Do you have to restart apache to make re-write rules in the .htaccess take effect?

A restart is not required for changes to .htaccess. Something else is wrong.

Make sure your .htaccess includes the statement

RewriteEngine on

which is required even if it's also present in httpd.conf. Also check that .htaccess is readable by the httpd process.
Check the error_log - it will tell you of any errors in .htaccess if it's being used. Putting an intentional syntax error in .htaccess is a good check to make sure the file is being used -- you should get a 500 error on any page in the same directory.

Lastly, you can enable a rewrite log using commands like the following in your httpd.conf:

RewriteLog "logs/rewritelog"

RewriteLogLevel 7

The log file thus generated will give you the gory detail of which rewrite rules matched and how they were handled.

No:

Apache allows for decentralized management of configuration via special files placed inside the web tree. The special files are usually called .htaccess, but any name can be specified in the AccessFileName directive... Since .htaccess files are read on every request, changes made in these files take immediate effect...

From the apache documentation: Most commonly, the problem is that AllowOverride is not set such that your configuration directives are being honored. Make sure that you don't have a AllowOverride None in effect for the file scope in question. A good test for this is to put garbage in your .htaccess file and reload. If a server error is not generated, then you almost certainly have AllowOverride None in effect.