Birth is "naștere", "nașterEA" is THE birth
Is the definite article necessary in the English translation, or can it be left out? If so, is it more correct to leave it out - "Birth is hard".
Both English translations should be accepted. You can't tell from the Romanian sentence whether it's about a specific birth or birth in general.
You are for sure right. I would also vote along the lines "giving birth is difficult" or so. The Romanian word is both verb and noun, and the semantic here is more toward verb.